hypomagnesemiarelated

Hypomagnesemia-related refers to conditions and clinical manifestations linked to low magnesium levels. Hypomagnesemia is typically defined as a serum magnesium concentration below 1.7 mg/dL (0.70 mmol/L). Magnesium is an essential intracellular cation involved in numerous enzymatic reactions and in the regulation of other electrolytes, especially calcium and potassium.

Common causes include inadequate intake or absorption (malnutrition, chronic diarrhea, inflammatory bowel disease, celiac disease), renal losses (loop diuretics, thiazides, aminoglycosides, cisplatin, certain immunosuppressants), endocrine and metabolic factors (hyperglycemia, refeeding syndrome), chronic alcoholism, and long-term proton pump inhibitor use. Genetic disorders such as Gitelman and Bartter syndromes also cause hypomagnesemia.

Pathophysiology involves magnesium's role as a cofactor for many enzymes and as a regulator of Na+/K+-ATPase and PTH release. Low magnesium promotes cellular excitability and can precipitate hypocalcemia and hypokalemia, contributing to arrhythmias and neuromuscular symptoms.

Clinical features range from nonspecific fatigue and weakness to tremor, muscle cramps, seizures, and neuromuscular irritability. Cardiac effects include prolonged QT intervals and increased risk of torsades de pointes, especially with concurrent electrolyte disturbances.

Diagnosis rests on serum magnesium measurement, recognizing that serum levels may not reflect total body magnesium in milder deficiencies. Urinary magnesium testing helps differentiate renal from nonrenal losses, and evaluation for associated electrolyte abnormalities is common.

Treatment depends on severity. Severe or symptomatic hypomagnesemia requires intravenous magnesium sulfate, typically 1-2 g given over an hour with repeat doses as needed and potassium or calcium repletion as indicated. Mild cases can be treated with oral magnesium supplements and addressing the underlying cause.

Prevention focuses on addressing risk factors such as poor nutrition, alcoholism, and drug-induced losses, with monitoring in high-risk populations.