Case Report

Fatal Hypermagnesemia Caused by an Epsom Salt Enema: A Case Illustration

Authors: Nancy M. Tofil, MD, Kim W. Benner, PHARMD, Margaret K. Winkler, MD

Abstract

The authors describe a case of fatal hypermagnesemia caused by an Epsom salt enema. A 7-year-old male presented with cardiac arrest and was found to have a serum magnesium level of 41.2 mg/dL (33.9 mEq/L) after having received an Epsom salt enema earlier that day. The medical history of Epsom salt, the common causes and symptoms of hypermagnesemia, and the treatment of hypermagnesemia are reviewed. The easy availability of magnesium, the subtle initial symptoms of hypermagnesemia, and the need for education about the toxicity of magnesium should be of interest to physicians.


Key Points


* Epsom salt is essentially 100% magnesium sulfate, and ingestion can result in hypermagnesemia.


* Hypermagnesemia should be in the differential diagnosis of a patient presenting as the result of unexplained cardiopulmonary arrest.


* Rapid identification and treatment of hypermagnesemia can be life saving.


* Epsom salt is easily available, and practitioners should be aware of its potential toxicity.

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