Total gastrectomy for severe proton pump inhibitor-induced hypomagnesemia in a MEN1/Zollinger Ellison syndrome patient.

Abstract

We report here the first case of life-threatening hypomagnesemia in a Zollinger-Ellison syndrome patient with multiple endocrine neoplasia type 1 (MEN1) syndrome. The severe symptomatic hypomagnesemia proved to be due to proton pump inhibitors (PPIs), but withdrawal of PPIs led to early severe peptic complications despite a substitution by histamine H2-receptor antagonist therapy. Simultaneous management of life-threatening hypomagnesemia, severe gastric acid hypersecretion and MEN1-associated gastrinomas was complex. A total gastrectomy was performed in order to definitely preclude the use of PPIs in this frail patient who was not eligible for curative pancreatoduodenal resection.

• Authors: Marine Perrier, Brigitte Delemer, Sophie Deguelte, Vincent Legros, Hedia Brixi, Reza Kianmanesh, Guillaume Cadiot
• Journal: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] (Pancreatology) Vol. 21 Issue 1 Pg. 236-239 (Jan 2021) ISSN: 1424-3911 [Electronic] Switzerland
• PMID: 33309626 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2020 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Chemical References

• Proton Pump Inhibitors

Topics

• Frailty
• Gastrectomy (methods)
• Humans
• Magnesium Deficiency (chemically induced, surgery)
• Male
• Middle Aged
• Multiple Endocrine Neoplasia Type 1 (complications, surgery)
• Peptic Ulcer (drug therapy)
• Proton Pump Inhibitors (adverse effects)
• Stomach (pathology)
• Treatment Outcome
• Zollinger-Ellison Syndrome (complications, surgery)