Endocrine Abstracts

A 73-year-old woman, admitted to emergency room due to generalized tonic–clonic seizures. She had a previous history of muscle cramps and paresthesia for 4 months. She had a medical history of peptic ulcer and she was taking omeprazole for 7 years. Her laboratory evaluation showed marked hypomagnesemia (<0.4 mg/dl normal ranges: 1.7–2.55 mg/dl) and hypocalcemia (6.83 mg/dl and normal ranges: 8.8–10.2 mg/dl) with extremely low urinary Ca and Mg excretion (<1.22 mg/day and 0.01 g/day respectively). Her vitamin D level was normal (34.47 IU) and PTH was increased (129 pg/ml and normal ranges: 15–65 pg/ml) in accordance with the secondary hyperparathyroidism. Symptoms resolved with the i.v. supplementation of calcium gluconate and magnesium sulphate. However despite high levels of oral replacement, Mg levels remained low. With omission of omeprazole 3 months after the admission her ion levels returned to normal without any replacement. We report a case of hypocalcemia and hypomagnesemia due to long-term proton pump inhibitor intake.