PPIs and hypomagnesemia

An elderly man with pins and needles in his legs and hands warrants investigation

Bernard is a 77-year-old male who reports several months' history of leg cramps and numbness involving his fingers.


His medical history includes ischaemic heart disease, hypertension, dyslipidaemia, gastro-oesophageal reflux disease, lumbar discitis, and a total replacement of his right knee.

His medications include aspirin, perindopril/amlodipine, atorvastatin, metoprolol, isosorbide mononitrate, rabeprazole, magnesium and calcium carbonate with vitamin D.

Bernard's symptoms of leg cramps and pins and needles have worsened over the past few months. He does not smoke and drinks three to four schooners of beer a day. Bernard denied any previous neck surgery or exposure to radiation.


His weight is 69kg, with a BMI of 28kg/m2. Bernard's sitting blood pressure is 160/80mmHg. Cardiorespiratory,