Etiologies associated with hypomagnesemia include:
A. Decreased vitamin D intake
B. Constipation
C. Malabsorption syndrome
D. Renal failure
Correct Answer: C. Malabsorption syndrome
Malabsorption syndrome is associated with hypomagnesemia. Increased vitamin D intake and diarrhea are also associated with hypomagnesemia. Magnesium deficiency and hypomagnesemia can result from a variety of causes including gastrointestinal and renal losses. Magnesium deficiency can cause a wide variety of features including hypocalcemia, hypokalemia, and cardiac and neurological manifestations.
Option A: Magnesium deficiency entirely due to reduced dietary intake in otherwise healthy subjects is very uncommon. Hypomagnesemia may be seen in patients who are maintained on magnesium-free intravenous fluids or total parenteral nutrition, especially in those patients who have a marginal or reduced serum magnesium to start off with.
Option B: Magnesium deficiency is frequently observed in conditions causing steatorrhea or severe chronic diarrhea such as Crohn’s disease, ulcerative colitis, celiac disease, Whipple’s disease, and short bowel syndrome. In general, the degree of magnesium depletion correlates with the severity of diarrhea, stool fat content, and fecal magnesium concentration.
Option D: Hypomagnesaemia is occasionally observed in chronic renal failure due to an obligatory renal magnesium loss. It is also seen during the diuretic phase of acute renal failure, in post-obstructive diuresis, and after renal transplantation.
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