Subcutaneous Magnesium Sulfate to Correct High-Output Ileostomy-Induced Hypomagnesemia

We describe the management of chronic hypomagnesemia and dehydration secondary to a high-output ileostomy following radiation and chemotherapy for anal squamous cell carcinoma with intermittent home-based subcutaneous magnesium infusions in a 61-year-old female with a history of Crohn ’s disease and multiple bowel resections. Despite aggressive management with intravenous magnesium sulfate and oral magnesium glucoheptonate over 8 months, 49% of her magnesium concentrations were #x3c;0.60 mmol/L (mean 0.61 ± 0.09) necessitating 4 emergency, 1 hospital, and 4 infusion clinic vis its. After initiation of subcutaneous magnesium sulfate, all magnesium concentrations were #x3e;0.60 mmol/L (mean 0.79 ± 0.08 mmol/L over 9 months). The patient tolerated the infusions well, only developing one minor episode of infusion-related cellulitis. A systematic review of the literature iden tified 14 reports where subcutaneous magnesium sulfatewas effective and treatment for adults or children with hypomagnesemia was safe. Home-based intermittent administration of subcutaneous magnesium may be a helpful and safe intervention to temporarily prevent and treat select patients with recurrent symptomatic hypomagnesemia.Case Rep Gastroenterol 2019;13:280 –293
Source: Case Reports in Gastroenterology - Category: Gastroenterology Source Type: research