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'''For patient information, click [[Hypermagnesemia (patient information)|here]]'''
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = {{PAGENAME}} |
   Name          = {{PAGENAME}} |
   Image          = Mg-TableImage.png  |
   Image          = Mg-TableImage.png  |
   Caption        = [[Magnesium]] |
   Caption        = [[Magnesium]] |
  DiseasesDB    = 6259 |
  ICD10          = {{ICD10|E|83|4|e|70}} |
  ICD9          = {{ICD9|275.2}} |
  ICDO          = |
  OMIM          = |
  MedlinePlus    = |
  eMedicineSubj  = med |
  eMedicineTopic = 3383|
  eMedicine_mult = {{eMedicine2|emerg|262}} {{eMedicine2|ped|1080}}  |
  MeshID        = |
}}
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{{SI}}
{{Hypermagnesemia}}
{{Editor Help}}
{{CMG}}
==[[Hypermagnesemia overview|Overview]]==


'''Hypermagnesemia''' is an [[electrolyte disturbance]] in which there is an abnormally elevated level of [[magnesium]] in the blood. Usually this results in excess of magnesium in the body. 
==[[Hypermagnesemia historical perspective|Historical Perspective]]==


Hypermagnesemia occurs rarely because the [[kidney]] is very effective in excreting excess magnesium. It usually develops only in people with kidney failure who are given magnesium salts or who take drugs that contain magnesium (e.g. some [[antacid]]s and [[laxative]]s).  It is usually concurrent with [[hypercalcemia]] and/or [[hyperkalemia]].
==[[Hypermagnesemia pathophysiology|Pathophysiology]]==


==Metabolism==
==[[Hypermagnesemia causes|Causes]]==
For a detailed description of magnesium [[homeostasis]] and [[metabolism]] see [[hypomagnesemia]].


==Symptoms==
==[[Hypermagnesemia differential diagnosis|Differentiating Hypermagnesemia from other Diseases]]==
* Weakness, nausea and vomiting
* [[Hypotension]]
* Impaired breathing
* [[Arrhythmia]] and [[asystole]], most prominent cardiac symptoms are due to conduction delays, since magnesium acts as physiologic [[Calcium channel blocker|calcium blocker]].


Clinical consequences related to serumconcentration:
==[[Hypermagnesemia epidemiology and demographics|Epidemiology and Demographics]]==
*4.0 mEq/l            [[hyporeflexia]]
*>5.0 mEq/l            Prolonged atrioventricular conduction
*>10.0 mEq/l          Complete [[heart block]]
*>13.0 mEq/l          [[Cardiac arrest]]


==Causes==
==[[Hypermagnesemia natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
Since magnesium is excreted through the [[kidney]]s, [[renal failure]] can result in hypermagnesemia. The most important cause however is suppletion.


===Predisposing conditions===
==Diagnosis==
*[[Hemolysis]], magnesium concentration in erythrocytes is approximately three times greater than in serum, therefore hemolysis can increase plasma magnesium. Hypermagnesemia is expected only in massive hemolysis.
[[Hypermagnesemia history and symptoms|History and Symptoms]] | [[Hypermagnesemia physical examination|Physical Examination]] | [[Hypermagnesemia laboratory findings|Laboratory Findings]] | [[Hypermagnesemia electrocardiogram|Electrocardiogram]] | [[Hypermagnesemia ultrasound|Ultrasound]]
*[[Renal insufficiency]], excretion of magnesium becomes impaired when [[creatinine clearance]] falls below 30 ml/min. However, hypermagnesemia is not a prominent feature of renal insufficiency unless magnesium intake is increased.
*Other conditions that can predispose to mild hypermagnesemia are [[diabetic ketoacidosis]], [[adrenal insufficiency]], [[hyperparathyroidism]] and [[lithium]] [[intoxication]].


==Therapy==
==Treatment==
Prevention of hypermagnesemia usually is possible. In mild cases, withdrawing magnesium suppletion is often sufficient. In more severe cases the following treatments are used:
[[Hypermagnesemia medical therapy|Medical Therapy]]
* [[Intravenous]] [[calcium gluconate]], because the actions of [[magnesium]] in [[neuromuscular]] and [[cardiac]] function are antagonized by [[calcium]].


Definitive treatment of hypermagnesemia requires increasing renal magnesium excretion through:
==Case Studies==
* Intravenous [[diuretic]]s, in the presence of normal [[renal function]]
[[Hypermagnesemia case study one|Case #1]]
* [[Dialysis]], when kidney function is impaired and the patient is symptomatic from hypermagnesemia


{{Endocrine, nutritional and metabolic pathology}}
{{Endocrine, nutritional and metabolic pathology}}

Latest revision as of 16:24, 7 February 2013

For patient information, click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Ultrasound

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Medical Therapy

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Case #1

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