Proton pump inhibitor-induced hypomagnesemia: A new challenge

Table 1 Symptoms and laboratory findings in patients with proton pump inhibitor-associated hypomagnesemia¹

Proton pump inhibitor	Symptoms	Laboratory findings	Ref.
Omeprazole	Diarrhea, vomiting, hallucinations, muscular excitability	Hypomagnesemia, hypocalcemia, hypophosphatemia and low urinary magnesium and calcium levels	[31]
Omeprazole	Muscle cramps, paresthesia, Trousseau’s sign, atrial flutter, pauses (4 s) in ECG	Hypomagnesemia, hypocalcemia and hypokalemia, PTH within the reference range	[31]
Omeprazole	Carpopedal and truncal spasm	Hypomagnesemia and hypocalcemia without an appropriate increase of PTH	[18]
Omeprazole, Esomeprazole, Pantoprazole, Rabeprazole (4 cases)	ECG abnormalities (QT interval prolongation, ST depression, Q waves)	Hypomagnesemia and hypocalcemia without an appropriate increase of PTH, hypokalemia, very low magnesium and calcium and increased potassium urinary levels	[19]
Omeprazole	Grand mal seizures	Hypomagnesemia, hypocalcemia, low urine magnesium levels	[17]
Esomeprazole	Lethargy, muscle cramps in extremities and abdomen	Hypomagnesemia, hypocalcemia, hypokalemia and low serum PTH levels, low urine magnesium levels	[20]
Omeprazole	Paresthesia, numbness, limb weakness	Hypomagnesemia, hypocalcemia, low vitamin D levels	[21]

¹We should note that not all cases described in the literature are presented in the Table because not all data was available. ECG: Electrocardiogram, PTH: Parathormone.