Pathogenetic Mechanisms of Hypomagnesemia in Alcoholic Patients

Elisaf, Moses; Merkouropoulos, Markos H.; Tsianos, E.V.; Siamopoulos, K. C.

doi:10.1016/s0946-672x(11)80026-x

Cited by 93 publications

(62 citation statements)

References 26 publications

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“…[23][24][25] This effect may augment other potential contributing factors in this clinical setting, including dietary deficiency, pancreatitis, or diarrhea. Several drugs have been associated with urinary Mg 2ϩ wasting, including aminoglycosides, amphotericin B, cisplatin, cyclosporin A, and pentamidine.…”

Section: ϩmentioning

confidence: 99%

Clinical Consequences and Management of Hypomagnesemia

Martin¹,

González²,

Slatopolsky

2009

Journal of the American Society of Nephrology

142

133

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Section: ϩmentioning

confidence: 99%

Clinical Consequences and Management of Hypomagnesemia

Martin¹,

González²,

Slatopolsky

2009

Journal of the American Society of Nephrology

142

133

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“…As occurred in this study, hypomagnesaemia is the most common electrolyte abnormality observed in alcoholic patients, and results from decreased magnesium intake, diarrhoea, respiratory alkalosis, inappropriate magnesium urinary excretion, and associated malnutrition (Flink, 1986;Elisaf et al, 1995). Likewise hypokalaemia, low serum magnesium is often asymptomatic (Flink, 1981); however, moderate or severe hypomagnesaemia is associated with seizures, paresthesia, ataxia, nystagmus, agitation, and cardiac arrhythmias, which can overlap severe clinical manifestations of alcohol abstinence (Flink, 1981).…”

Section: Discussionmentioning

confidence: 82%

Serum electrolytes in hospitalized pellagra alcoholics

et al. 2000

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Background: Owing to high diarrhoea and protein malnutrition frequencies in pellagra, we hypothesised that pellagra patients would have higher electrolyte disturbances than non-pellagra alcoholics. Objective: To compare serum electrolytes of hospitalised alcoholics with or without pellagra. Design: Retrospective and descriptive case-control study. Setting: Internal Medicine wards at a University Hospital, Medical School of Uberaba, Brazil. Subjects: Medical records were reviewed to obtain relevant clinical details, main diagnosis and laboratory data, including serum electrolytes on hospital admission of pellagra patients (n 33) and a randomly chosen control group of alcoholics (n 37), matched in age, gender and socio-economic status. Anaemia was ascertained by haemoglobin`12.5 gadl (men) and 1.5 gadl (women), and hypoalbuminemia by serum albumin`3.3 gadl. Results: Pellagra and controls showed similar age (39.4 AE 13.1 vs 45.0 AE 11.4 years) and a male predominance of gender (69.7 vs 78.4%), and similar associated diagnoses, including high blood pressure (21.2 vs 16.2%), peripheral neuropathy (12.1 vs 13.5%), and pneumonia (9.1 vs 13.5%). Despite displaying similar serum sodium (136.6 AE 6.1 vs 137.8 AE 5.7 mEqaI), magnesium (1.72 AE 0.74 vs 1.62 AE 0.34 mgadl), phosphorus (3.79 AE 0.87 vs 3.87 AE 0.78 mEqa1) than controls,in addition to higher hypoalbuminemia (76.2 vs 33%) and anaemia (60.6 vs 35.1%) frequencies. Conclusions: Higher anaemia and hypoalbuminemia frequencies associated with lower serum potassium levels suggest increased protein malnutrition prevalence among pellagrins.

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“…In one study; hypophosphatemia was found in about 50% of alcoholics who are admitted to hospital, while hypomagnesemia was found in up to 30% of alcoholics [7–9]. The clinical significance and severity of these electrolyte disturbances depend on the duration and quantity of alcohol consumption.…”

Section: Discussionmentioning

confidence: 99%

Severe hypokalemia with cardiac arrest as an unusual manifestation of alcoholism

Abdulfattah

Rahman

Alnafoosi

et al. 2018

Journal of Community Hospital Internal Medicine Perspectives

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Introduction: Unhealthy use of alcohol can be associated with serious adverse events. Patients with alcoholism and malnutrition are at high risk for electrolyte disturbances, commonly hypokalemia. Here in we describe a case of alcohol use disorder presented with weakness and subsequently developed cardiac arrest secondary to severe hypokalemia.Case description: A 51-year-old lady presented to our emergency department because of generalized body ache and marked weakness in both lower extremities for two days duration. She had a long-term history of alcoholism, consuming two to three pints of vodka every day for about 20 years. Her last drink of alcohol was about 48 hours prior to presentation. Her examination revealed bilateral lower limb weakness of 4/5, with intact sensory system and reflexes. Biochemical analysis of the serum showed severe electrolytes disturbance, a potassium level of 2.3 mmol/L (reference 3.6−5.1 mmol/L). Electrocardiogram (ECG) showed no arrhythmias, but changes characteristic of hypokalemia with marked corrected QT segment prolongation (QTc 551ms). Aggressive supplementation of electrolytes was initiated, however, potassium level failed to increase and subsequently she had a sinus bradycardia followed by cardiac arrest. Cardiopulmonary resuscitation was initiated, return of spontaneous circulation was obtained. During the following days, potassium supplementation was continued to achieve normal plasma potassium level. She was then discharged from the hospital with recommendations for abstinence from alcohol.Conclusion: Patients with chronic alcohol-use can have serious electrolyte disturbances including hypokalemia which can have life-threatening consequences. Prolonged potassium supplementation over several days is required to achieve normal level of plasma potassium and replenish total-body potassium deficit.

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Pathogenetic Mechanisms of Hypomagnesemia in Alcoholic Patients

Cited by 93 publications

References 26 publications

Clinical Consequences and Management of Hypomagnesemia

Clinical Consequences and Management of Hypomagnesemia

Serum electrolytes in hospitalized pellagra alcoholics

Severe hypokalemia with cardiac arrest as an unusual manifestation of alcoholism

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