Summary
A case report of a 54-year-old previously healthy man who presented to the emergency department with altered consciousness, generalized weakness, stupor, hypothermia, hypotension, and generalized areflexia after inadvertent ingestion of approximately 100 mL of a private-label artificial hot-spring mineral preparation (nominal formulation approximately 30% magnesium chloride, 33% magnesium sulfate, 10% potassium sulfate). Initial serum magnesium was 15.8 mg/dL (reference range 1.7 to 2.4 mg/dL). Standard initial treatment (intravenous calcium, saline, loop diuretic) did not produce meaningful neurological improvement. Emergent hemodialysis reduced serum magnesium to 4.9 mg/dL during treatment with rapid neurological recovery. The patient recovered without residual complications.
Key numbers
- Serum Mg2+ on presentation: 15.8 mg/dL (severely elevated; normal range 1.7 to 2.4 mg/dL) (p. 1 abstract)
- Serum Mg2+ after hemodialysis: 4.9 mg/dL (p. 1 abstract)
- Exposure source: approximately 100 mL of a magnesium-rich bath preparation with nominal 30% MgCl2, 33% MgSO4, 10% K2SO4 (p. 1 abstract)
- ECG: diffuse ST-segment depression; AI-ECG model estimated mortality risk above the 99th percentile (p. 1 abstract)
- Normal serum creatinine at presentation (indicating intact renal function at time of acute event) (p. 1 abstract)
- Recovery: complete, without residual complications (p. 1 abstract)
Evidence Fitness
Context only. Single case report; n = 1. The case documents the clinical presentation of severe acute hypermagnesemia from non-dietary oral magnesium exposure (bath agent), confirms the neuromuscular and cardiovascular toxidrome, and establishes that severe toxicity can occur with intact renal function when the acute magnesium load is large. The case cannot quantify dietary risk, establish dose-response thresholds, or generalize to exposure from food.
Methods (brief)
Clinical case report with laboratory measurements (serum Mg2+, creatinine, ECG), clinical documentation, and AI-enabled ECG mortality risk estimation. Hemodialysis was both the treatment and the principal observation modality. Retrospective history-taking after stabilization established the exposure source.
Implications
- Courses: useful illustration of acute hypermagnesemia toxidrome (neuromuscular and cardiovascular effects, including areflexia, hypotension, ECG changes) and the importance of hemodialysis when standard treatment is insufficient; also illustrates that normal renal function at presentation does not preclude life-threatening toxicity from a large acute magnesium load.
- App: no contamination_profile implication.
- Microbiome: no direct connection.
Provenance notes
Open access (cc-by). Retrieved from PMC Open Access S3 (PMC13713025). SHA256 verified against MANIFEST.csv.
Related evidence
Update history
No substantive edit history is available in this build. The full commit record is available in git.