ArticleJCEM case reports2026
Severe hypomagnesemia and secondary hypocalcemia associated with vonoprazan in a patient with type 2 diabetes.
Article in JCEM case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Hypomagnesemia is a well-known complication of long-term proton pump inhibitor usage; the stronger acid-suppressive effect of potassium-competitive acid blockers (P-CABs) may increase the risk of hypomagnesemia to a similar or greater extent. However, reports of P-CAB-associated hypomagnesemia are scarce. A 78-year-old Japanese man with a history of type 2 diabetes and myocardial infarction, who was receiving low-dose aspirin and long-term vonoprazan, presented with epigastric discomfort. Laboratory testing revealed significant hypocalcemia, hypomagnesemia, and low intact parathyroid hormone levels, which were consistent with functional hypoparathyroidism. Electrocardiogram (ECG) showed QTc prolongation and frequent premature ventricular contractions. Urinary magnesium excretion was low, suggesting impaired intestinal magnesium absorption rather than renal loss. Vonoprazan was discontinued, and magnesium and calcium supplementation was initiated. Electrolyte abnormalities normalized by day 3, and ECG changes subsequently resolved. No recurrence occurred after switching to an H
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