Hypomagnesemia due to Renal Magnesium Wastage of Unknown Etiology

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A twenty-two year old woman, investigated because of tetanic convulsion and refractory hypocalcemia, was shown to have hypomagnesemia, hypokalemia, hypocalciuria and hypophosphaturia. The patient sometimes had loose stool but no steatorrhea. Bowel absorption test of D-Xylose, 131I-triolein and 47Ca were in the normal range. Relative hypermagnesuria was observed despite of hypomagnesemia. Renal function was normal. Parathyroid hormone level was quite low but showed a rapid increase after the injection of magnesium supplement. Normal responsiveness to parathyroid hormone was observed in the kidney. Oral administration of magnesium supplement resulted in relief of subjective symptoms as well as normal serum levels of calcium and potassium. During this period, serum magnesium rose up but never reached the normal level. These findings suggested that renal magnesium wastage of unknown etiology was the significant factor contributing to the hypomagnesemia and that hypocalcemia was probable due to impaired serection of PTH. The mechanism of the hypokalemia observed with the magnesium depletion remains unknown.
1981-10-25