Causes of Magnesium Wasting
by Herbert C. Mansmann Jr., M.D.*, and Shawna Kopchu RN**
Many people already know that when you take diuretics (Water Pills) you need to take a potassium supplement since potassium is lost through the urine. This is also true for Mg. There are certain medications and lifestyle behaviors that can cause excessive Mg loss in the urine. If you are on any of these medications or display any of the lifestyle behaviors you will need to take a Mg supplement to accommodate the loss and prevent hypomagnesemia. There are also specific diseases that can cause Mg loss in the urine and are listed below.
Bartter’s Syndrome Comes of Age
In 1962, Bartter and co-workers [1] published a description of two patients presenting with a new syndrome characterized by hypokalemia, metabolic alkalosis, hyperaldosteronism with normal blood pressure, decreased pressor responsiveness to infused angiotensin II, and hyperplasia of the juxtaglomerular complex. Since then, many reports, both in children and in adults, have appeared in the literature under the heading of “Bartter’s syndrome.” It is nowadays evident that this term does not represent a unique entity but encompasses a variety of disorders of renal electrolyte transport all characterized by a biochemical picture of hyperreninemic hypokalemic metabolic alkalosis. At the present time this ensemble of patients can be divided into three different genetic and clinical entities [2] :
Bartter’s Syndrome, 1962
Hyperplasia of the Juxtaglomerular Complex with Hyperaldosteronism and Hypokalemic Alkalosis, A New Syndrome
Frederic C. Bartter M.D.
HYPERPLASIA and hypertrophy of the juxtaglomerular apparatus, and primary aldosteronism with hypokalemic alkalosis were found associated with normal blood pressure in two patients [1] . This coexistence of a histologic lesion not previously described with a rare disease entity suggests an association between them; the appearance of these disorders in two patients who have never had hypertension appears to represent a new syndrome.
Hypocalcemic Seizures in Neonates
A case of a 2-week-old infant who presented to the emergency department (ED) with rapid eye blinking and jerking in the absence of physical abnormalities is presented. Hypocalcemia and hypomagnesemia were detected. This case represents the common presentation, therapy, and outcome of neonatal hypocalcemia. It is of particular interest to ED physicians because most of the time the etiology of neonatal seizures can be diagnosed in the ED and appropriate therapy can be immediately instituted.
Nephrolithiasis
By David A. Bushinsky, University of Rochester School of Medicine and Dentistry, Nephrology Unit, Strong Memorial Hospital, Rochester, New York.
The incidence of nephrolithiasis appears to be slightly in excess of one case per 1000 patients per year and has been slowly increasing in recent decades [1] [2] . Kidney stones often cause severe pain, which may lead to emergent hospitalization, shock-wave lithotripsy, and/or surgery. An understanding of the mechanisms involved in kidney stone formation leads to rational treatment which has been documented to decrease the incidence of nephrolithiasis and its associated morbidity.
Premenstrual Syndrome
Obstetrics and Gynecology Clinics, Volume 27 Number 3 September 2000
Copyright 2000 W. B. Saunders Company, CURRENT REPRODUCTIVE ENDOCRINOLOGY
Advances in Diagnosis and Treatment
Bruce Kessel MD
Department of Obstetrics, Gynecology, and Women’s Health, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii
Premenstrual syndrome (PMS) is characterized by the occurrence of a constellation of symptoms temporally associated with the menstrual cycle. Symptoms of PMS include physical and mood changes that peak premenstrually and resolve shortly following the onset of menstrual bleeding. Historical descriptions of PMS are shrouded in mythology, and, previously, the scientific understanding of PMS was limited.
Restless Leg Syndrome
Restless legs syndrome (RLS) is characterized by unpleasant sensations of the legs that are worse in the evening and at night, and that are relieved by movement. Most patients with RLS also have movements of the legs that occur periodically at 20- to 30-second intervals for minutes to hours during sleep. Although the term nocturnal myoclonus sometimes is used to describe these movements, they usually are not sudden lightning-like movements. Rather, they typically last for about 1 second and consist of extension of the great toe with variable degrees of ankle extension, knee extension, and hip extension or flexion.
Potassium Sparing Medications
Amiloride works by inhibiting sodium reabsorption in the distal convoluted tubules and collecting ducts in the kidneys. This promotes the loss of sodium and water from the body, but without depleting potassium. The drug is often used in conjunction with thiazide or loop diuretics. Patients with Bartter or Gitelman Syndromes benefit from this by keeping their potassium levels up.
Potassium-sparing diuretics are commonly used to help reduce the amount of water in the body. Unlike some other diuretics, these medicines do not cause your body to lose potassium.
Growth Hormone and Gitelman’s Syndrome
Recombinant Human Growth Hormone and Gitelman’s Syndrome
Gitelman’s syndrome is a primary renal tubular disorder with hypokalemic metabolic alkalosis, hypocalciuria, and magnesium deficiency. Short stature is one of clinical manifestations in children. The pathogenesis of short stature in Gitelman’s syndrome is not known. To evaluate whether growth hormone (GH) is deficient and whether recombinant human GH (rhGH) improves growth rate, rhGH therapy was tried in a child with Gitelman’s syndrome.
Genetic Cause of Antenatal Bartter Syndrome
Large Deletion of the 5th End of the ROMK1 Gene Causes Antenatal Bartter Syndrome
Abstract. Mutations in exon 5 of the ROMK1 gene ( KCNJ1) have recently been observed in antenatal Bartter syndrome patients. This study describes a homozygous deletion removing KCNJ1 exons 1 and 2 observed in a consanguineous family with antenatal Bartter syndrome.