Hypermagnesemia

Introduction When the serum magnesium concentration exceeds the normal value, it is hypermagnesemia, and the blood [Mg2]>1.05mmoL/L or more, except for a few iatrogenic factors, which cause excessive magnesium in the body, most of which are caused by renal dysfunction. Reduced. As with hypomagnesemia, serum magnesium concentration is not a reliable indicator of magnesium increase, because 25% of magnesium in serum binds to protein, and this part of magnesium does not exert physiological effects. Magnesium ions are mainly in cells, so when the body is magnesium When the content is increased, the serum magnesium can be in the normal range. However, in general, the degree of hypermagnesemia and the increase in body magnesium are consistent.

Cause

Acute or chronic renal failure is more common, but in general, patients with renal failure can still maintain normal or normal high levels of blood magnesium, and no symptoms caused by hypermagnesemia. If excessive intake (such as the use of antacids) or excessive access to the body through other means (such as intramuscular injection of magnesium sulfate, etc.), there may be significant hypermagnesemia and symptoms. In addition, thyroxine can inhibit renal magnesium reabsorption and promote urinary magnesium excretion, so some patients with mucinous edema can develop hypermagnesemia.

an examination

Related inspection

Urinary magnesium serum magnesium (Mg2+, Mg)

1. Increased serum magnesium concentration (sera magnesium > 1.25mmol / L) can directly diagnose hypermagnesemia.

2.24h urinary magnesium elimination is of great help in diagnosing the cause. If the amount of loss is reduced, it is caused by renal factors, endocrine factors, and metabolic factors, otherwise it is caused by increased intake or abnormal distribution.

3. Electrocardiogram examination: conduction block and bradycardia appear. The electrocardiogram of hypermagnesemia showed prolongation of PR interval, QRS broadening and prolongation of QT interval.

Differential diagnosis

Mild hypermagnesemia, symptoms and signs are often missing, easy to be ignored, for patients with magnesium, especially patients with renal insufficiency should pay attention to monitoring blood magnesium concentration, combined with urinary magnesium determination, primary underlying disease Diagnosis and differential diagnosis are made.

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