alexa Hydroxyurea therapy associated with declining serum levels of magnesium in children with sickle cell anemia.


Journal of Cardiovascular Diseases & Diagnosis

Author(s): Altura RA, Wang WC, Wynn L, Altura BM, Altura BT

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Abstract OBJECTIVE: To obtain quantitative serum levels of total and ionized magnesium (Mg(2+)) in children with homozygous sickle cell anemia (SCA) undergoing therapy with hydroxyurea. STUDY DESIGN: Five children, ages 11 to 14 years with homozygous SCA, were enrolled in a dose-escalating trial of hydroxyurea over an 18-month period. Serum levels of total and ionized magnesium together with ionized K(+), Na(+), and Ca(2+) were measured before hydroxyurea and every 6 months during hydroxyurea therapy. RESULTS: Before treatment, 4 of the 5 patients had low or below-normal serum concentrations of Mg(2+) (normal range, 0.51-0.67 mmol/L). All 5 became Mg(2+)-deficient during hydroxyurea therapy, with no indication of recovery until after 12 to 18 months of drug administration (P <.05). Similar changes were noted for total magnesium concentrations. Mean serum levels of K(+), Na(+), and Ca(2+) remained consistently within normal ranges. CONCLUSIONS: These findings warrant a controlled study of the effects of magnesium supplementation in patients with SCA receiving hydroxyurea. Potentially, such therapy could alleviate or prevent vaso-occlusive crises. This article was published in J Pediatr and referenced in Journal of Cardiovascular Diseases & Diagnosis

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