Korean J Nephrol.  2008 Mar;27(2):229-233.

A Case of Hypermagnesemia with Cardio-respiratory Failure in a Patient with Chronic Renal Failure

• Park CH
• Lim CH
• Chang HJ
• Son SW
• Jung S
• Park CW
• Chang YS

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.

Keyword

Chronic renal failure; Dialysis; Magnesium

MeSH Terms

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
Amylases
Cathartics
Magnesium