HİPERMAGNEZEMİ

Öz

Hipermagnezemi çoğunlukla aşırı Mg alımı ve böbrek fonksiyon bozukluğu kombinasyonu ile ortaya çıkmaktadır. Teşhisi serum Mg düzeylerinin ölçümü ile konmaktadır. Derecesi ve belirtilerin ciddiyetine göre tedavisi kaçınılmaz bir elektrolit bozukluğudur. Hafif yükseklikte basitçe Mg kaynağının ortadan kaldırılması yeterlidir. Ciddi nöromüsküler ve kardiyovasküler semptomları olanlarda böbrek yetersizliği tablosuna göre hidrasyon, diüretik, diyaliz, hemodiyaliz ve yenidoğanlarda kan değişimi tedavi seçeneklerini oluşturmaktadır. Ciddi aritmi ve solunum depresyonu gibi hayatı tehdit edici bir tablo varsa kalsiyum ile Mg’a ait etkiler antagonize edilmelidir. Hipermagnezemi yapan medikasyonlar açısından dikkat edilmeli ve hasta eğitimi yapılmalıdır.

Kaynakça

1. KAYNAKLAR
2. Soave PM, Conti G, Costa R, Arcangeli A. Magnesium and anaesthesia. Curr Drug Targets. 2009;10(8):734-43.
3. Reinhart RA. Magnesium metabolism. Arch Int Med. 1988;148:2415-2420.
4. Musso CG. Magnesium metabolism in health and disease. Int Urol Nephrol. 2009;41(2):357-62.
5. Kaze Folefack F, Stoermann Chopard C. [Magnesium metabolism disturbances]. Rev Med Suisse. 2007;3(101):605-6, 608, 610-1.
6. Moe SM. Disorders involving calcium, phosphorus, and magnesium. Prim Care 2008;35(2):215-37, v-vi.
7. Henry JB. Clinical Diagnosis and Management by Laboratory Methods, 19th ed. Philadelphia; W.B.Saunders Company 1996, p197-8.
8. Quamme GA. Control of magnesium transport in the thick ascending limb. Am J Physiol. 1989;256(2 Pt 2):F197-210.

9. Konrad M, Schlingmann KP, Gudermann T. Insights into the molecular nature of magnesium homeostasis. Am J Physiol Renal Physiol 2004; 286: F599-F605.
10. Navarro-Gonzalez JF, Mora-Fernandez C, Garcia-Perez J. Clinical implications of disordered magnesium homeostasis in chronic renal failure and dialysis. Semin Dialn2009;22(1):37-44.
11. Elin RJ. Determination of Serum Magnesium Concentration by Clinical Laboratories. Magnes Trace Elem1991; 10: 60-6.
12. Henry RJ, Cannon DC, Winkelman JW. Clinical chemistry principles and techniques, ed 2, New York, Harper & Row Publishers, Inc, 1974.
13. Gindler EM, Heth DA. Colorimetric determination with bound “Calmagite” of magnesium in human blood serum. Clin Chem 1971; 17: 663.
14. Hulanicki A. Magnesium: chemical properties and methods of determination. Clin Chem Enzym Commun 1993; 5: 135-42.
15. Saris NL, Mervaala E, Karppannen H, Khawaja JA, Lewenstam A. Magnesium An Update on Physiological, Clinical and Analytical Aspect. Clinica Chimica Acta 2000; 294:1-26.
16. Malinowska E, Meyerhoff M. Potentiometric response of magnesium selective membrane electrode in the presence of nonionic surfactants. Anal Chim Acta 1999; 382: 265-75.
17. Cohen I, Laor A. Correlation between bone magnesium concentration and magnesium retention in the intravenous magnesium load test. Magnes Res 1990; 3: 271-4.
18. Maj-Zurawska M, Hulanicki A, Drygieniec D et al. Ionized and total magnesium level in blood serum and plasma of healthy and ill adults. Electroanalysis 1993; 5: 713-7.
19. Kulpmann WR, Rademacher E, Bornscheuer B. Ionized magnesium concentration during liver transplantation, resection of the liver and cardiac surgery. Scand J Clin Lab Invest 1996; 56(224): 235-43.
20. Altura BM, Altura BT. Magnesium in cardiovascular biology. Sci Am Sci Med 1995; 2: 28-37.
21. Altura BT, Memon ZI, Zhang A et al. Low levels of serum ionized magnesium are found in patients early after stroke which result inrapid elevation in cytosolic free calcium and spasm in cerebral vascular muscle cells. Neurosci Lett 1997; 230: 37-40.
22. Handwerker SM, Altura BT, Altura BM. Ionized magnesium and potassium levels in pregnant women with preeclampsia and eclampsia. J Reprod Med 1995; 40: 201-8.
23. Huijgen HJ, Sanders R, Van Olden RW, Klous MG, Gaffar FR, Sanders GT. Intracellular and extracellular blood magnesium fraction in hemodialysis patients; is the ionized fraction a measure of magnesium excess? Clin Chem 1998; 44: 639-48.36-41.
24. Sayarlıoğlu M, Bayraktaroğlu T, Trablus S, Aras Ş, Sayarlıoğlu H, Bahtiyar İ. Hipertansif olan ve olmayan tip 2 diabetes mellitus’lu (NIDDM) hastalarda intraeritrositer magnezyum düzeyi. Türkiye Tıp Dergisi, 1999;6:24-28.
25. Sayarlıoğlu M, Bayraktaroğlu T, Aras Ş, Trablus S Sayarlıoğlu H, Bahtiyar İ. Tip 2 diabetes mellitus’ta (NIDDM) intraeritrositer magnezyum düzeyi ve glisemi regulasyonu ile ilişkisi. Türk Diabet Yıllığı 1999;272-277.
26. Elin RJ. Magnesium metabolism in health and disease. Dis Mon 1988; 34:165-218.
27. Saris NL, Mervaala E, Karppannen H, et al. Magnesium An Update on Physiological, Clinical and Analytical Aspect. Clinica Chimica Acta 2000; 294:1-26.
28. Romani AM, Scarpa A. Regulation of cell magnesium. Arch Biochem Biophys 1992; 298: 1-12.
29. Özgürtaş T, Kutluay T. Magnezyum metabolizması ve ölçümü. T Klin Tıp Bilimleri 2002;22:530-534.
30. Türkiye Endokrinoloji ve Metabolizma Hastalıkları Derneği, Osteoporoz ve Diğer Metabolik Kemik Hastalıkları Çalışma Grubu. Hipermagnezemi. Metabolik Kemik Hastalıkları Tanı ve Tedavi Kılavuzu. Galenos Yayınevi, Özgün Ofset Tic. Ltd. Şti. 2012, 1.Baskı, 86-88.
31. Guillaume T, Krzesinski JM. [Management of serum magnesium abnormalities]. Rev Med Liege 2003;58(7-8):465-7.
32. Drueke TB, Lacour B. Disorders of calcium, phosphate and magnesium metabolism. In: Feehally J, Floege J, Johnson RJ, eds. Comprehensive Clinical Nephrology. 3rd ed. Philadelphia, Pa: Mosby; 2007:137-8.
33. Bringhurst FR, Demay MB, Krane SM, et al. Bone and mineral metabolism in health and disease/hypermagnesemia. In: Kasper DL, et al, eds. Harrison's Principles of Internal Medicine. 16th ed. New York, NY: McGraw-Hill; 2005:2245.
34. Corbi G, Acanfora D, Iannuzzi GL, et al. Hypermagnesemia predicts mortality in elderly with congestive heart disease: relationship with laxative and antacid use. Rejuvenation Res. 2008;11(1):129-38.
35. Swain R, Kaplan-Machlis B. Magnesium for the next millennium. South Med J 1999; 92(11): 1040-7.
36. So M, Ito H, Sobue K, et al. Circulatory collapse caused by unnoticed hypermagnesemia in a hospitalized patient. J Anesth 2007;21(2):273-6.
37. Woodard JA, Shannon M, Lacouture PG, et al. Serum magnesium concentrations after repetitive magnesium cathartic administration. Am J Emerg Med 1990;8(4):297-300.
38. Clark BA, Brown RS. Unsuspected morbid hypermagnesemia in elderly patients. Am J Nephrol 1992;12(5):336-43.
39. Leong DP, Kleinig TJ, Kimber TE, Bardy PG. Severe hypermagnesaemia related to laxative use in acute gastrointestinal graft-versus-host disease. Bone Marrow Transplant 2006;38(1):71-2.
40. Which anticonvulsant for women with eclampsia? Evidence from the Collaborative Eclampsia Trial. Lancet 10 1995;345(8963):1455-63.
41. Toyoshima K, Momma K, Nakanishi T. Fetal reversed constrictive effect of indomethacin and postnatal delayed closure of the ductus arteriosus following administration of transplacental magnesium sulfate in rats. Neonatology 2009;96(2):125-131.
42. Donovan EF, Tsang RC, Steichen JJ, et al. Neonatal hypermagnesemia: effect on parathyroid hormone and calcium homeostasis. J Pediatr. 1980;96(2):305-10.
43. Hyun HS, Choi HS, Kim JK, Ahn SY, Yoo HS, Kim ES, et al. Idiopathic severe hypermagnesemia in an extremely low birth weight infant on the first day of life. Korean J Pediatr 2011;54(7):310-2.
44. Rasch DK, Huber PA, Richardson CJ, et al. Neurobehavioral effects of neonatal hypermagnesemia. J Pediatr 1982;100(2):272-6.
45. ,.Tzanakis IP, Papadaki AN, Wei M, et al. Magnesium carbonate for phosphate control in patients on hemodialysis. A randomized controlled trial. Int Urol Nephrol 2008;40(1):193-201.
46. Wyskida K, Witkowicz J, Chudek J, Wiecek A. Daily magnesium intake and hypermagnesemia in hemodialysis patients with chronic kidney disease. J Ren Nutr 2012;22(1):19-26.
47. Law WM Jr, Heath H 3rd. Familial benign hypercalcemia (hypocalciuric hypercalcemia). Clinical and pathogenetic studies in 21 families. Ann Intern Med 1985;102(4):511-9.
48. Pearce SH, Trump D, Wooding C, et al. Calcium-sensing receptor mutations in familial benign hypercalcemia and neonatal hyperparathyroidism. J Clin Invest 1995;96(6):2683-92.
49. Schmid-Elsaesser R, Kunz M, Zausinger S, et al. Intravenous magnesium versus nimodipine in the treatment of patients with aneurysmal subarachnoid hemorrhage: a randomized study. Neurosurgery 2006;58(6):1054-65; discussion 1054-65.
50. Arango MF, Mejia-Mantilla JH. Magnesium for acute traumatic brain injury. Cochrane Database Syst Rev 2006;CD005400.
51. ,Agus ZS, Morad M. Modulation of cardiac ion channels by magnesium. Annu Rev Physiol. 1991;53:299-307.
52. Cholst IN, Steinberg SF, Tropper PJ, et al. The influence of hypermagnesemia on serum calcium and parathyroid hormone levels in human subjects. N Engl J Med 1984;310(19):1221-5.
53. Cruikshank DP, Pitkin RM, Reynolds WA, et al. Effects of magnesium sulfate treatment on perinatal calcium metabolism. I. Maternal and fetal responses. Am J Obstet Gynecol 1979; 134(3): 243-9.
54. Agus ZS Causes and treatment of hypermagnesemia. Section ed:Goldfarb S. UpToDate 2011.
55. Bringhurst FR, Demay MB, Kronenberg M. Hormones and disorders of mineral metabolism. In Williams Textbook of Endocrinology. Eds. Kronenberg HM, Melmed S, Polonsky KS, Larsen PR. Chapter 27, 11th ed. Saunders, Philadelphia 2008;1203-68.