Hypocalcemia and hypomagnesemia after ibuprofen overdose.

OBJECTIVE

To report a case of hypocalcemia and hypomagnesemia after ibuprofen overdose.

CASE SUMMARY: A 21-month-old boy developed acute renal failure with severe metabolic acidosis after ingestion of ibuprofen 8 g. The infant developed tonic-clonic seizures 46 hours after ingestion, with significant hypocalcemia and hypomagnesemia that required electrolyte replacement to control the seizures.

DISCUSSION: To our knowledge this is the first case report of hypocalcemia, hypomagnesemia, and seizures in a patient after ibuprofen overdose. The mechanism is unclear, the situation was probably aggravated by the use of sodium polystyrene sulfonate and furosemide.

CONCLUSIONS

In patients with ibuprofen overdose, serum calcium and magnesium concentrations should be evaluated since seizures may be associated with a deficiency of these cations. The management of these patients should include calcium and/or magnesium supplementation when required and furosemide should be avoided.