Differential Diagnosis for Hypermagnesemia
Single Most Likely Diagnosis
- Chronic Kidney Disease (CKD): The most common cause of hypermagnesemia is CKD, as the kidneys are responsible for excreting excess magnesium. Impaired renal function leads to decreased magnesium excretion, resulting in elevated serum levels.
Other Likely Diagnoses
- Excessive Magnesium Intake: Ingestion of large amounts of magnesium, either through supplements or certain medications like antacids and laxatives, can lead to hypermagnesemia, especially in individuals with normal kidney function.
- Hypothyroidism: This condition can decrease the renal clearance of magnesium, potentially leading to hypermagnesemia.
- Adrenal Insufficiency: Similar to hypothyroidism, adrenal insufficiency can affect renal function and magnesium excretion, contributing to elevated magnesium levels.
Do Not Miss Diagnoses
- Lithium Therapy: Lithium can impair renal function, leading to decreased magnesium excretion and potential hypermagnesemia. Although less common, missing this diagnosis could have significant clinical implications.
- Rhabdomyolysis: This condition involves the breakdown of muscle tissue, releasing magnesium into the bloodstream. Although rare, it is a critical diagnosis not to miss due to its severe clinical consequences.
Rare Diagnoses
- Familial Hypocalciuric Hypercalcemia: A rare genetic disorder that can lead to hypermagnesemia due to altered calcium and magnesium handling in the kidneys.
- Magnesium-Containing Cathartics Abuse: Rarely, individuals may abuse magnesium-containing cathartics, leading to severe hypermagnesemia.
- Tumor Lysis Syndrome: Although more commonly associated with hyperkalemia, hyperphosphatemia, and hypocalcemia, tumor lysis syndrome can also lead to the release of intracellular magnesium, resulting in hypermagnesemia.