Hypomagnesemia, a side effect of proton-pump inhibitors (PPIs), can be asymptomatic. The presence of hypocalcemia or hypokalemia is indicative of hypomagnesemia; however, the concomitant use of PPIs and thiazide may mask hypocalcemia. A 79-year-old woman with a history of chronic heart failure and chronic kidney disease developed symptomatic hypocalcemia and hypomagnesemia. Five weeks earlier, she had developed thiazide-induced hyponatremia, so thiazide had been discontinued. Reviewing the patient’s charts revealed that three discontinued thiazide administrations in the clinical course had unmasked hypocalcemia. Our case demonstrates that thiazide-induced hypercalcemia can be so prominent as to mask PPI-induced hypocalcemia and hypomagnesemia.
CITATION STYLE
Uehara, A., Kita, Y., Sumi, H., & Shibagaki, Y. (2019). Proton-pump inhibitor-induced severe hypomagnesemia and hypocalcemia are clinically masked by thiazide diuretic. Internal Medicine, 58(15), 2201–2205. https://doi.org/10.2169/internalmedicine.2608-18
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