OBJETIVO: O objetivo desse estudo foi verificar a associação do nível sérico do magnésio com o uso de inibidores de bomba de prótons (IBP) e outros fatores. MÉTODOS: Realizou-se estudo transversal com 151 pacientes admitidos com doenças agudas no serviço de medicina interna do Hospital de Clínicas de Porto Alegre. Foram excluídos aqueles pacientes com condições usualmente relacionadas à hipomagnesemia: diarréia; vômitos; diabéticos agudamente descompensados; uso crônico de laxantes, álcool, diuréticos ou outros fármacos relacionados. RESULTADOS: Todos os pacientes apresentaram níveis normais de magnésio. Albumina e creatinina sérica se associaram positivamente com os níveis de magnésio sérico, após ajuste para fatores confundidores. Não houve diferença no nível sérico de magnésio em usuários ou não-usuários de IBP ou entre homens e mulheres. Não houve correlação com idade, nível sérico de fósforo e potássio. As principais limitações desse estudo foram a ausência de instrumento para medir a adesão aos IBPs e o tamanho da amostra. CONCLUSÃO: A associação do uso de IBP e hipomagnesemia é rara. Defeitos congênitos no metabolismo do magnésio devem ser responsáveis pelo surgimento de hipomagnesemia em usuários de dessa classe de fármacos.
OBJECTIVE: The aim of this study was to evaluate the association of serum magnesium levels with proton pump inhibitors (PPIs) use and other factors. METHODS: This was a cross-sectional study of 151 patients admitted with acute diseases in the Internal Medicine Division of the Hospital de Clinicas de Porto Alegre, after the exclusion of conditions that are commonly associated with hypomagnesemia: diarrhea; vomiting; chronic alcohol use; severely uncompensated diabetes mellitus; and chronic use of laxatives, diuretics or other drugs causing magnesium deficiency. RESULTS: All patients had normal serum magnesium levels. Serum albumin and creatinine levels were positively associated with serum magnesium levels, after adjusting for confounders. There was no difference between mean serum magnesium levels of PPI users and non-users, nor between men and women; there was also no correlation among age, serum phosphorus, and potassium levels with serum magnesium levels. Limitations of this study include the absence of an instrument for measuring adherence to PPI use and the sample size. CONCLUSION: The association of PPI use and hypomagnesemia is uncommon. Congenital defects in the metabolism of magnesium may be responsible for hypomagnesemia in some patients using this drug class.
Meningitis is a severe and potentially fatal form of tuberculosis. The diagnostic workup involves detection of acid-fast bacilli (AFB) in the cerebrospinal fluid (CSF) by microscopy or culture, however, the difficulty in detecting the organism poses a challenge to diagnosis. The use of the polymerase chain reaction (PCR) in the diagnostic approach to Mycobacterium tuberculosis (MTB) meningitis has been reported as a fast and accurate method, with several commercial kits available. As an alternative, some institutions have been developing inexpensive in house assays. In our institution, we use an in house PCR for tuberculosis. We analyzed the performance of our PCR for the diagnosis of MTB meningitis in 148 consecutive patients, using MTB culture as gold standard. The sensitivity and specificity of CSF PCR for the diagnosis of MTB meningitis was 50% and 98.6% respectively with a concordance with CSF mycobacterial culture of 96% (Kappa=0.52). In contrast to CSF cultures for MTB, our PCR test is a fast, simple and inexpensive tool to diagnose tuberculous meningitis with a performance similar to that obtained with the available commercial kits.