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

Pancreatology. 2021 Jan;21(1):236-239. doi: 10.1016/j.pan.2020.12.002. Epub 2020 Dec 7.

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.

Keywords: Gastrinoma; Hypomagnesemia; Multiple endocrine neoplasia type 1 syndrome; Proton pump inhibitor; Total gastrectomy; Zollinger-Ellison syndrome.

Publication types

  • Case Reports

MeSH terms

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

Substances

  • Proton Pump Inhibitors