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Case Reports in Nephrology
Volume 2016, Article ID 2608538, 3 pages
http://dx.doi.org/10.1155/2016/2608538
Case Report

Suppression of Parathyroid Hormone in a Patient with Severe Magnesium Depletion

Department of Nephrology and Hypertension, University of Texas Medical Branch, 4.200 John Sealy Annex, Galveston, TX 77555-0562, USA

Received 1 February 2016; Accepted 31 March 2016

Academic Editor: Ricardo Enríquez

Copyright © 2016 Sangeeta Mutnuri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hypomagnesemia is often associated with coexisting electrolyte abnormalities like hypokalemia and hypocalcemia. Hypocalcemia has been shown to be secondary to hypoparathyroidism induced by hypomagnesemia. Here, we discuss a case of a patient with severe hypomagnesemia and associated hypocalcemia. A 38-year-old lady was admitted to the hospital for weakness of lower extremities and an eventual fall. The exam was significant for decreased motor strength and some paresthesias. The laboratory data was significant for hypomagnesemia, hypokalemia, and low parathyroid level in the face of hypocalcemia. After replacing magnesium, the parathyroid hormone levels normalized and led to eventual correction of calcium levels without any additional calcium replacement therapy. There was complete symptom resolution with correction of electrolyte abnormalities. This case highlights the importance of looking for all associated abnormalities in a patient with hypomagnesemia and starting the replacement therapy by first replacing the magnesium and then the others as needed. Replacing the magnesium alone may correct the hypoparathyroidism and eliminate the need for calcium replacement.