A Case of Hypermagnesemia with Cardio-respiratory Failure in a Patient with Chronic Renal Failure.
- Author:
Cheol Hong PARK
1
;
Chang Hoon LIM
;
Hyoung Jin CHANG
;
Sang Won SON
;
Sungjin JUNG
;
Cheol Whee PARK
;
Yoon Sik CHANG
Author Information
1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. cheolwhee@hanmail.net
- Publication Type:Case Report
- Keywords:
Chronic renal failure;
Dialysis;
Magnesium
- MeSH:
Abdominal Pain;
Amylases;
Cathartics;
Coma;
Constipation;
Dialysis;
Eating;
Enema;
Female;
Hemodynamics;
Hemofiltration;
Humans;
Hypotension;
Ileus;
Kidney Failure, Chronic;
Lethargy;
Magnesium;
Middle Aged;
Pancreatitis;
Polyarteritis Nodosa;
Renal Replacement Therapy;
Respiration, Artificial;
Respiratory Insufficiency;
Stress, Psychological
- From:Korean Journal of Nephrology
2008;27(2):229-233
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A 46-year-old woman with chronic renal failure due to polyarteritis nodosa was referred to the hospital for evaluation of abdominal pain. She had been treated with cathartics (magnesium oxidate 2.0 g/day) for constipation for several days. One day before the admission, the patient had been taken magnesium enema twice at another hospital. On admission, she was comatose, suffering from lethargy and respiratory failure. Her serum magnesium and amylase concentrations were markedly elevated (8.2 mg/dL and 1,698 IU/L respectively), and plain abdominal image and abdominal computed tomography revealed acute pancreatitis and non-obstuctive ileus. Thereafter, aggressive cardiopulomonary support with mechanical ventilation and continuous renal replacement therapy using continuous veno-venous hemofiltration (CVVH) applied due to cardio-respiratory failure and hypermagnesemia. After 3 days of CVVH treatment, the concentration of serum magnesium was normalized to 3.2 mg/dL, and respiratory failure and abdominal ileus were markedly improved. Four days after aggressive treatment, her hemodynamic and gastroenteric symptoms stabilized. Therefore, we report the case of hypermagnesemia with acute pancreatitis, severe hypotension and respiratory failure after cathartic ingestion and enema containing magnesium oxidate treated with CVVH.
