Naslov
Role of laboratory in management severe hypomagnesemia with associated hypocalcemia and hypokalemia after renal transplantation: A case report

Autori
Perkov, Sonja ; Ivić, Matea ; Taradi, Ida ; Knotek, Mladen ; Prkačin, Ingrid ; Kardum Paro, Mirjana Mariana

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
23rd IFCC-EFLM European Congress of Clinical Chemistry and Laboratory Medicine / Delanghe, Joris ; Wu, Alan H - Amsterdam : Elsevier, 2019, S211-s211

Skup
23rd IFCC-EFLM European Congress of Clinical Chemistry and Laboratory Medicine (EUROMEDLAB 2019)

Mjesto i datum
Barcelona, Španjolska, 19.05.2019. - 23.05.2019

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
hypomagnesemia ; hypocalcemia ; hypokalemia ; renal transplantation

Sažetak
Background-aim. Hypomagnesemia is frequently observed after renal transplantation (RTx), in part to immunosuppressive regimens including calcineurin inhibitors that induce magnesium(Mg)urinary waste. Symptoms of Mg deficiency can be nonspecific and usually overlap with symptoms of other electrolyte imbalances. The severity of symptoms and signs depends on the degree of Mg depletion and rate of Mg decline. In this case report the role of accredited medical biochemical laboratory in management of severe hypomagnesemia associated with other electrolyte imbalances in patient after RTx is presented. Methods. A 64-year-old woman presents to the Department of Nephrology and Dialysis, Merkur University Hospital Zagreb, Croatia with legs pain. In 2008 she underwent RTx and started immunosuppressive treatment with tacrolimus. The diagnosis of hypomagnesemia and hypocalcemia was found. All laboratory methods used were accredited according to ISO 15189 norm. The patient was treated with hydration, calcium and magnesium therapy with carefully biochemical and clinical monitoring. Results. Laboratory diagnostics were performed on admission showing severe hypokaliemia (serum potasium: 3, 4 mmol/L), severe hypomagnesemia (serum total Mg: b0, 20 mmol/L, ionized Mg: b0, 20 mmol/L), severe hypokalcemia (serum total calcium (Ca): 1, 19 mmol/L, ionized Ca: 1, 00 mmol/L) metabolic acidosis (arterial pH: 7, 308 ; actual bicarbonate: 11, 3 mmol/L and base excess: -15, 0 mmol/ L), renal disfunction (urea 10, 3 mmol/L, creatinine 137 umol/L), mild normochromic normocytic anemia (eritrocytes: 2, 32×1012/L and hemoglobin 73 g/L) and slightly elevated C-reactive protein (8, 4 mg/ L), Longitudinal evaluation of the Ca and Mg results showed that the total Ca rose from 1, 19 on admissionto 2, 27 mmol/L on day 12, while the total Mg concentrations rose from 0, 20 to 0, 60 mmol/L on day 1 and then trended down to 0, 38 mmol/L on day 12. Conclusions. Changes in the concentration of ionized magnesium can occur without corresponding changes in total magnesium and its routine determination should be a part of urgent laboratory diagnostics. The role of laboratory in management of electrolyte imbalances is of most important for timely and proper diagnosis as well as their treatment through constant and timely high risk results reporting.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA