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.