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Clinical concerns arise from a small but growing number of case reports presenting <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>\u2010induced hypomagnesaemia (<jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content>) as a consequence of long\u2010term <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> use. Current opinion is that reduced intestinal magnesium absorption might be involved, but nothing is known on the molecular mechanism underlying <jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To investigate whether or not <jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content> is a true, long\u2010term drug\u2010class effect of all <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>s and to scrutinise a possible role of comorbidity in its aetiology. Therefore, the primary objective in particular was to investigate serum magnesium dynamics in trials drug withdrawal and re\u2010challenge. The secondary objective was to profile the \u2018patient at risk\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed systematically all currently available case reports on the subject and performed a statistical analysis on extracted data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Proton pump inhibitor\u2010induced hypomagnesaemia <jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content> is a drug\u2010class effect and occurred after 5.5\u00a0years (median) of <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content> use, onset was broad and ranged from 14\u00a0days to 13\u00a0years. Discontinuation of <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>s resulted in fast recovery from <jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content> in 4\u00a0days and re\u2010challenge led to reoccurrence within 4\u00a0days. Histamine\u20102\u2010receptor antagonists were the preferable replacement therapy in <jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content> and prevented reoccurrence of hypomagnesaemia. In <jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content> no specific risk profile was identified that was linked to the hypomagnesaemia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The cases of <jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content> show severe symptoms of magnesium depletion and identification of its causation was only possible through withdrawal of the <jats:styled-content style=\"fixed-case\">PPI<\/jats:styled-content>. Clinical awareness of <jats:styled-content style=\"fixed-case\">PPIH<\/jats:styled-content> is key to avoid putting patients at risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2036.2012.05201.x","type":"journal-article","created":{"date-parts":[[2012,7,4]],"date-time":"2012-07-04T23:47:14Z","timestamp":1341445634000},"page":"405-413","source":"Crossref","is-referenced-by-count":181,"title":["Systematic review: hypomagnesaemia induced by proton pump inhibition"],"prefix":"10.1111","volume":"36","author":[{"given":"M. W.","family":"Hess","sequence":"first","affiliation":[{"name":"Department of Physiology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. G. J.","family":"Hoenderop","sequence":"additional","affiliation":[{"name":"Department of Physiology Radboud University Nijmegen Medical Centre Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J. 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