An unexpected side effect of long term Proton Pump Inhibitors use

Tirelli P, Gammaldi V, Bologna C, Ciarambino T, Cacciapuoti F De Sena A, Coppola MG, Lugara M, Tartaglia B, Petrosino CP de Luca C, Granato Corigliano F, Guerra M, Oliva G, Paradisone P, P. Madonna

Department of Internal Medicine, �??Ospedale del Mare�?�, Hospital; Naples, Italy
Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
Internal Medicine Department, Hospital of Marcianise, ASL Caserta, Caserta, Italy
Department of Cardiovascular Diseases, Antonio Cardarelli Hospital, Naples, Italy

Scientific Tracks Abstracts: Health Sci J

Abstract:

Background Hypomagnesaemia is a side effect of long term Proton Pump Inhibitors (PPIs) use. It can cause arrhythmias, tetany, seizure, and it can be a life-threatening condition. Case History We describe the case of a 77-year-old man with history of remote stroke, chronic ischemic heart disease, and hypertension, pulmonary embolism, presented at the emergency department with generalized tonic clonic seizures (TCZ). Brain CT and Brain MRI were negative for acute lesions and laboratory tests showed moderate hypokalemia and severe hypomagnesaemia. After excluding other causes for hypomagnesaemia, long term PPIs use was considered a plausible cause of a gastrointestinal malabsorption. The patient underwent a gastroscopy which showed a hyperplasic micropolypoid-like mucosa, indicative of chronic gastropathy. Therefore, substitutive therapy was initiated to restore blood levels of magnesium and potassium, and PPIs were discontinued. Subsequently, patient was discharged at home without any significant neurologic deficits. Conclusion The long term PPIs use can play a role in determining severe hypomagnesaemia and so physicians should consider the rare but serious side effect of PPIs and review the indication to long term PPIs use to prevent potential hypomagnesaemia which could cause a life-threatening condition.
References :
1. Visconti M (2015) Proton pump inhibitors overuse: only inappropriate prescriptions or further iatrogenic damage? Italian J Med 9: 217-218.
2. Seah S, Tan YK, Teh K (2023) Proton-pump inhibitor use amongst patients with severe hypomagnesemia. Front Pharmacol 14:1092476.

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