Pathogenesis of Hypocalcemia in Primary Hypomagnesemia: Normal End-Organ Responsiveness to Parathyroid Hormone, Impaired Parathyroid Gland Function

Suh, Se Mo; Tashjian, Armen H.; Matsuo, Nobutake; Parkinson, David K.; Fraser, Donald R.

doi:10.1172/jci107159

Cited by 203 publications

(65 citation statements)

References 20 publications

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“…No data on urinary CAMP is available in these patients. Other patients with hypomagnesemia,however, show normal renal responses to PTH (3,4,6). Hyperphosphatemia is a rare complication in magnesium deficiency (16,29), whereas hypocalcemia has been reported frequently.…”

Section: Discussionmentioning

confidence: 99%

Renal Refractoriness to Phosphaturic Action of Parathyroid Hormone in a Patient with Hypomagnesemia.

et al. 1995

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A 50-year-old tetanic womanwith hypomagnesemiais described. She had partial resection of the stomach and thejejunum at the age of20 years. Lack of parathyroid hormone (PTH) function was indicated by hypocalcemia, hyperphosphatemia and high tubular reabsorption of phosphate. However, both plasma concentration of PTHand nephrogenous CAMP were normal. Administration of magnesiumsulfate completely normalized serum phosphate and tubular transport of phosphate with only a modest increase in nephrogenous CAMP. The present findings suggest that phosphaturic action of PTHis impaired in magnesiumdeficiency and that steps distal to CAMP production may be responsible for the renal refractoriness to the hormonal action. (Internal Medicine 34: 666-669, 1995)

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Section: Discussionmentioning

confidence: 99%

Renal Refractoriness to Phosphaturic Action of Parathyroid Hormone in a Patient with Hypomagnesemia.

et al. 1995

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“…Mustering and handling of cattle for collection of blood or urine samples may precipitate grass tetany in susceptible cows, and may be impractical when many cows in the mob have young calves at foot. In human medicine, subclinical hypomagnesaemia is associated with diabetes, metabolic syndrome and cardiovascular disease [82,83], and may also have a negative impact on the ability to cope with hypocalcaemia, since adequate magnesium level is important for both the excretion of parathyroid hormone [84] and the tissue responsiveness to parathyroid hormone [85].…”

Section: Diagnosing Grass Tetanymentioning

confidence: 99%

Hypomagnesemia Tetany in Cattle

Zelal¹

2017

J Adv Dairy Res

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Grass tetany, sometimes called grass staggers or hypomagnesemia, can be a serious problem in Syria with cattle grazing small grain or ryegrass pastures. hypomagnesemia tetany has been known under a variety of names, including magnesium tetany, lactation tetany and grass staggers, but most of these terms have been discarded because the disease is not always associated with lactation or with grazing animals.The exact cause of hypomagnesemia tetany in ruminant animals is a dietary deficiency of magnesium that may be a contributory factor. Some research workers consider the condition to be caused by a cation-anion imbalance in the diet, and Some research workers believe that high intake of the element (K & Na) may interfere with the absorption and metabolism of magnesium in the animal, which may be an important factor in the etiology of hypomagnesemia tetany.Although the exact cause of hypomagnesemia is still uncertain, the primary factor would appear to be inadequate absorption of magnesium from the digestive tract. A high degree of success in preventing hypomagnesemia may be obtained by increasing the magnesium intake. This can be effected by feeding with magnesium rich mineral mixtures or, alternatively, by increasing the magnesium content of pasture by the application of magnesium fertilizers.

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“…1 Impaired synthesis and secretion of parathyroid hormone (PTH) as a consequence of profound hypomagnesemia have been suggested to be responsible for the observed hypocalcemia. 2,3 Early diagnosis is decisive to avoid neurological problems that can lead to permanent neurological injury or even sudden death as a consequence of arrhythmias in extreme cases. 4,5 In HSH patients, serum magnesium (Mg 2 þ ) levels dramatically fall below the normal range (0.2-0.4 vs 0.70-0.95 mmol/l).…”

Section: Introductionmentioning

confidence: 99%

New TRPM6 missense mutations linked to hypomagnesemia with secondary hypocalcemia

et al. 2013

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Despite recent progress in our understanding of renal magnesium (Mg 2 þ ) handling, the molecular mechanisms accounting for transepithelial Mg 2 þ transport are still poorly understood. Mutations in the TRPM6 gene, encoding the epithelial Mg 2 þ channel TRPM6 (transient receptor potential melastatin 6), have been proven to be the molecular cause of hypomagnesemia with secondary hypocalcemia (HSH; OMIM 602014). HSH manifests in the newborn period being characterized by very low serum Mg 2 þ levels (o0.4 mmol/l) accompanied by low serum calcium (Ca 2 þ ) concentrations. A proportion of previously described TRPM6 mutations lead to a truncated TRPM6 protein resulting in a complete loss-of-function of the ion channel. In addition, five-point mutations have been previously described. The aim of this study was to complement the current clinical picture by adding the molecular data from five new missense mutations found in five patients with HSH. To this end, patch-clamp analysis and cell surface measurements were performed to assess the effect of the various mutations on TRPM6 channel function. All mutant channels, expressed in HEK293 cells, showed loss-of-function, whereas no severe trafficking impairment to the plasma membrane surface was observed. We conclude that the new TRPM6 missense mutations lead to dysregulated intestinal/renal Mg 2 þ (re)absorption as a consequence of loss of TRPM6 channel function.

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Pathogenesis of Hypocalcemia in Primary Hypomagnesemia: Normal End-Organ Responsiveness to Parathyroid Hormone, Impaired Parathyroid Gland Function

Abstract: A B S T R A C T Hypocalcemia is

Cited by 203 publications

References 20 publications

Renal Refractoriness to Phosphaturic Action of Parathyroid Hormone in a Patient with Hypomagnesemia.

Renal Refractoriness to Phosphaturic Action of Parathyroid Hormone in a Patient with Hypomagnesemia.

Hypomagnesemia Tetany in Cattle

New TRPM6 missense mutations linked to hypomagnesemia with secondary hypocalcemia

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