IJCRR - 6(6), March, 2014
Pages: 80-83
SEVERE HYPOMAGNESEMIA, HYPOKALEMIA AND HYPOCALCEMIA ASSOCIATED WITH PULMONARY TUBERCULOSIS
Author: Baskaran S., Gopi Manigandan, Arumugam Aashish
Category: Healthcare
[Download PDF]
Abstract:
We report a case of severe hypomagnesemia, hypokalemia and hypocalcemia in a 55-year-old lady who defaulted her treatment twice for pulmonary tuberculosis and presented with tetany to the emergency room. Hypocalcemia and hypokalemia persisted despite adequate correction and improved only after the correction of hypomagnesemia. The biochemical abnormalities were further complicated by streptomycin therapy necessitating to modify the anti-tuberculous regimen. The association of hypomagnesemia with tuberculosis is reported earlier and this association is attributed to renal magnesium wasting following aminoglycoside containing anti tuberculous regimen. However, hypomagnesemia contributing to hypocalcemia and hypokalemia, occurring as a primary abnormality in patients with tuberculosis is reported rarely. Here we report a case of active pulmonary tuberculosis who presented with such rare manifestations. This report emphasizes the need to maintain a high index of clinical suspicion of hypomagnesemia in patients with tuberculosis and in those receiving aminoglycoside as a part of their anti tuberculous therapy (ATT).
Keywords: hypomagnesemia, hypokalemia, hypocalcemia, pulmonary tuberculosis
Citation:
Baskaran S., Gopi Manigandan, Arumugam Aashish. SEVERE HYPOMAGNESEMIA, HYPOKALEMIA AND HYPOCALCEMIA ASSOCIATED WITH PULMONARY TUBERCULOSIS International Journal of Current Research and Review. 6(6), March, 80-83
References:
REFERENCES
1. Limaye CS, Londhey VA, Nadkar MY, Borges NE. Hypomagnesemia in critically ill medical patients. Journal of associations of physicians of India 2011; 59:19-22.
2. Wong ET, Rude RK, Singer FR. A high prevalence of hypomagnesemia in hospitalized patients. Am J clin pathol 1983; 79: 348-352.
3. Ahsan SK. Metabolism of magnesium in health and disease. J Ind Med Assoc 1997; 95(9):507-10.
4. Zalman S.Agus. Hypomagnesemia. J AM Soc Nephrol 1999; 10:1616-1622.
5. Biswajit das, Prassanna Chandra, K.V Thimmaraju. A Comparitive study of serum magnesium in pulmonary tuberculosis and bronchial asthma. International Journal of Pharma and Bio Sciences 2011; 2(3): B 23-29.
6. Jain MK Khanuo sk, Chandre RD, Jain GC, Bisarya BN. Serum magnesium in pulmonary tuberculosis. IND.J.Tuber 1976; 23:177-181.
7. Shin S Furin J, Alcantra F et al. Hypokalemia among patients receiving treatment for multi drug resistant tuberculosis. Chest 2004; 125:974-80.
8. Aquinas M, Citron k. Rifampicin, ethambutol and capreomycin in pulmonary tuberculosis, previously treated with both first and second line drugs: the results of two years chemotherapy. Tubercle 1972; 53:153-65.
9. Vanasin B, Colmer M, Davis P. Hypocalcemia hypomagnesemia and hypokalemia during chemotherapy of pulmonary tuberculosis. Chest 1972; 61:496-99.
10. Chou-Long Huang, Elizabeth Kuo. Mechanism of hypokalemia in magnesium deficiency. J AM SOC Nephrol 2007; 18 (10):2649-2652.
11. Chase LR, Slatopolsky E. Secretion and metabolic efficiency of parathyroid hormone in patients with severe hypomagnesemia. J Clin Endocrinal Metab 1974; 38: 363-371.
12. Rude RK, Oldhan SB, Singer FR. Functional hypoparathyroidism and parathyroid hormone end organ resistance in human magnesium deficiency. Clin Endocrinol 1976 5:209-224.
13. Martin R.Pollak, Alan.S.L.Yu, Eric N.Taylor. Disorders of Calcium Magnesium and Phosphate imbalance. In: Barry M.Brenner. Brenner and Rector’s The Kidney. 8th(ed). vol 1; Philadelphia: Saunders, 2007:596-601
14. Avinash K Shetty, N Lymn Rogurs, Elizabeth E Mannick, Diego H. Aviles. Syndrome of hypokalemic metabolic alkalosis and hypomagnesemia associated with gentamicin therapy: case reports. CLIN PAEDIATR 2009; 39:529-533.
|