Hypomagnesaemia-hypocalcaemia syndrome in the postpartum period. A case report.

A black woman had amoebic dysentery for 5 days before delivery of her 7th child. The day after delivery at home she was admitted to hospital with puerperal sepsis, vaginal bleeding and dysentery. The patient received gentamicin from the 4th to the 10th day after admission and the diarrhoea continued until the 11th day, when she developed tetany. Investigation revealed hypocalcaemia, hypomagnesaemia and hypokalaemia; urinary magnesium excretion was at the upper limit of the reference range; infusion of parathyroid hormone adenosine monophosphate excretion. Magnesium replacement therapy was instituted and normal serum calcium, magnesium and potassium levels were re-established on this treatment alone. These findings are interpreted as being consistent with magnesium depletion by diarrhoea and gentamicin therapy, resulting in the induction of a functional hypoparathyroidism.