21/26. magnesium deficiency in the eosinophilia-myalgia syndrome. Report of clinical and biochemical improvement with repletion.We describe a patient with the eosinophilia-myalgia syndrome (EMS) with persistent myalgias, cramping, and weakness that were not responsive to treatment. Despite a normal serum magnesium level, a loading study was performed, and the results suggested low tissue levels of magnesium. He was given parenteral magnesium and had dramatic improvement in symptoms as well as in muscle intracellular levels of this cation. After cessation of magnesium therapy the symptoms recurred, and magnesium repletion again led to an improvement in symptoms and ATP levels. Low tissue levels of magnesium, even in the setting of normal serum levels, may lead to the neuromuscular symptoms in EMS and related disorders.- - - - - - - - - - ranking = 1keywords = cramp, muscle (Clic here for more details about this article) |
22/26. magnesium deficiency as a cause of hypocalcemia in the CHARGE association.OBJECTIVE: To discover the mechanism of hypocalcemia in a patient with the CHARGE (coloboma, heart disease, atresia choanae, retarded growth and development, genital hypoplasia, and ear anomalies) association. research design: Chemical and metabolic studies of serum, urine, stool, and muscle specimens. SETTING: A university hospital affiliated with a municipal hospital. PARTICIPANT: One patient with the CHARGE association and refractory hypocalcemia. MEASUREMENTS AND RESULTS: serum calcium level was 0.91 mmol/L (reference range, 2.20 to 2.58 mmol/L) and serum magnesium level was 0.34 mmol/L (reference range, 0.80 to 1.20 mmol/L) prior to any therapy. After parenteral calcium and magnesium therapy, hypocalcemia persisted (1.46 mmol/L), while the serum magnesium level was 0.84 mmol/L. A needle biopsy of skeletal muscle tissue for the magnesium content confirmed a total magnesium deficiency despite normomagnesemia (muscle magnesium content, 517 micrograms/g [reference range, 800 to 1100 micrograms/g]). magnesium deficiency was secondary to secretion of magnesium into the gastrointestinal tract (with a daily magnesium intake of 190 mg, a 24-hour nondiarrheal fecal excretion of magnesium was 2019 mg/kg [reference range, < 1000 mg/kg of stool weight]). INTERVENTIONS: hypocalcemia was corrected only after 7 weeks of continual parenteral magnesium supplements to replenish the tissue magnesium deficiency. CONCLUSIONS: patients with the CHARGE association often have hypocalcemia. magnesium deficiency (with or without hypomagnesemia) is a cause of the hypocalcemia in at least one patient and may prove of significance in others.- - - - - - - - - - ranking = 0.0047134302579004keywords = muscle (Clic here for more details about this article) |
23/26. foscarnet-induced severe hypomagnesemia and other electrolyte disorders.OBJECTIVE: To report a case of possible foscarnet-induced severe hypomagnesemia and other electrolyte disorders. CASE SUMMARY: An AIDS patient experienced an exacerbation of cytomegalovirus retinitis and was treated with foscarnet. The patient experienced muscle twitches, tremulousness, and anxiety on day 17 of foscarnet therapy. Laboratory results indicated hypomagnesemia, hypocalcemia, hypokalemia, and hypophosphatemia. After electrolyte supplementation and discontinuation of foscarnet, the symptoms resolved and laboratory indices returned to normal. DISCUSSION: Electrolyte disorders associated with foscarnet are reviewed. Severe hypomagnesemia occurred in this patient and published literature is highlighted. In addition, known and/or possible mechanisms of the disorders are discussed. CONCLUSIONS: It is probable that foscarnet contributed to the electrolyte disorders and symptomatology in this patient. electrolytes must be monitored frequently during foscarnet therapy. Also, concomitant therapy with antianxiety medications that may mask the symptoms of electrolyte disorders should be undertaken with caution.- - - - - - - - - - ranking = 0.0015711434193001keywords = muscle (Clic here for more details about this article) |
24/26. Muscle cramps and magnesium deficiency: case reports.magnesium deficiency is more common than is believed. This article discusses florid magnesium deficiency in two patients and the results of treatment. While neither case was difficult to diagnose, the severity of symptoms was unusual. magnesium deficiency should always be included in the differential diagnosis of patients who present with persistent or severe muscle pain.- - - - - - - - - - ranking = 3.9952865697421keywords = cramp, muscle (Clic here for more details about this article) |
25/26. Bartter's syndrome in pregnancy: a case report and review.Bartter's syndrome is a rare autosomal recessive disorder characterized by hypokalemia, hyperaldosteronism, sodium wasting, normal blood pressure, hypochloremic alkalosis, and hyperplasia of the juxtaglomerular apparatus. We present a 21-year-old African-American nulliparous patient who was referred to our clinic at 9 weeks' gestation with a history of Bartter's syndrome. Her antenatal course was complicated by muscle cramps, which required increasing potassium supplementation. She developed hypomagnesemia in the third trimester of pregnancy, which necessitated magnesium therapy. She delivered an unaffected infant at term. Bartter's syndrome, although extremely rare in pregnancy, requires prompt recognition and careful management, as it may have significant maternal and neonatal implications.- - - - - - - - - - ranking = 12.17430688442keywords = muscle cramp, cramp, muscle (Clic here for more details about this article) |
26/26. Hypomagnesemia and smooth muscle contractility: diffuse esophageal spasm in an old female patient.The aim of this paper is to describe and discuss, on the basis of the available literature, the case of an old female patient, admitted to our university hospital because of a severe dysphagia for solid foods, in whom laboratory data showed a marked hypomagnesemia. She reported a long history (20 years) of allergic bronchial asthma treated with theophylline. Esophagography evidenced a disorder of esophagus motility with diffuse multiple spasm, reminiscent of the 'corkscrew esophagus'. A link with the severe hypomagnesemia (Mg 1.1 mEq/l, normal range 1.6-2.1) was suspected, and a therapy with oral pidolate of Mg (1.5 g/twice a day) was started and continued for 4 months. This was associated with a slow progressive normalization of the Mg plasma level and reverted radiographic esophageal findings with disappearance of dysphagia. Mg is an important element for health and disease, and today Mg deficiency in man has become an accepted medical problem which might complicate many diseases. Neuromuscular disorders, as laryngeal spasm, are recognized complications of hypomagnesemia, but until now only 1 case of motor esophageal disorder associated with a low Mg plasma level was briefly reported in the literature, even if dysphagia is generally included in the symptomatological pattern of hypomagnesemia. Our observation of a severe form of esophageal spasm, associated with hypomagnesemia, in an aged female patient underlines the pathophysiological meaning of the plasma Mg level and suggests the need for routine Mg determination in the clinical setting.- - - - - - - - - - ranking = 0.0062845736772006keywords = muscle (Clic here for more details about this article) |
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