| A Case of Hypermagnesemia with Cardio-respiratory Failure in a Patient with Chronic Renal Failure |
| Cheol Hong Park, M.D., Chang Hoon Lim, M.D., Hyoung Jin Chang, M.D. Sang Won Son, M.D., Sungjin Jung, M.D., Cheol Whee Park, M.D. and Yoon Sik Chang, M.D. |
| Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea |
| 증례 : 만성 신부전에서 심폐 부전이 동반된 고마그네슘혈증 1예 |
| 박철홍, 임창훈, 장형진, 손상원, 정성진, 박철휘, 장윤식 |
| 가톨릭대학교 의과대학 내과학교실 신장내과 |
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| Abstract |
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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. |
| Key Words:
Chronic renal failure, Dialysis, Magnesium |
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