Answering Nazek:
Disorders of Magnesium Balance (1)
Introduction Magnesium is the most abundant intracellular divalent cation and, after calcium, the most common divalent cation in the body. The majority (99%) of magnesium residing inside cells. Consequently, plasma magnesium concentration does not reflect total body magnesium. Magnesium plays an important role in neuromuscular coupling, largely through its interaction with calcium. Disorders of magnesium primarily reflect hypomagnesemia, with cardiac arrhythmias and other features similar to those of low calcium. Among the causes of hypomagnesemia are malnutrition, chronic alcoholism, kidney abnormalities and malabsorption. [Is she taking any laxatives?]
Magnesium Intake and Distribution Magnesium is found in many foods, including green vegetables and meat products, and the normal diet is usually more than ample. Approximately 5 mg/kg per day of magnesium is required for normal magnesium balance. Factors that control gastrointestinal magnesium absorption are unclear, but about one-third of ingested magnesium is absorbed.
Magnesium Excretion The distal nephron (part of the kidney), however, is the major site of fine regulation of magnesium excretion. Loop-acting diuretics predictably have a potent magnesium-wasting effect. [Is she taking any ‘Water Pills?], [One-Alpha should only be given to patients suffering from kidney disease. Is that the case here?]
Role of Magnesium The major role of magnesium is as a cofactor for hundreds of identified enzymes that produce or require ATP, such as kinases, ATPase, and adenylyl cyclase. Disorders of magnesium may lead to impaired energy production, substrate utilization, and synthetic processes.
Hypomagnesemia (Low magnesium) ESSENTIALS OF DIAGNOSIS
• Plasma [Mg2+] <1.7 style="color: rgb(255, 102, 102);">The numbers given satisfy this criterion.] • Cardiac arrhythmias, refractory potassium deficiency. [What was her potassium level?] • Features suggestive of hypocalcemia: tetany, weakness, increased deep tendon reflexes, altered mental status, and seizures. [Are there any symptoms like these?]
[Please provide also the laboratory reference levels for any result mentioned as this varies between laboratories.]
References
1. Bongard FS, STAT!Ref, Teton Data Systems. Current critical care diagnosis & treatment. 3rd ed. New York ;London: McGraw-Hill; 2008.
[Above doesn’t replace the input of a medical professional who interviews the patient and carries out a physical examination followed by a discussion of care – that is the premier method of obtaining medical advice at this time of medical science development].
