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Severe, Symptomatic Hypomagnesemia in Acute Leptospirosis

Anne SpichlerDepartment of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious Diseases, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil; Department of Biointeraction, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Infectious Diseases, Heliopolis General Hospital, São Paulo, Brazil; Division of Infectious Diseases, University of California San Diego School of Medicine, La Jolla, California

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Daniel A. AthanazioDepartment of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious Diseases, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil; Department of Biointeraction, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Infectious Diseases, Heliopolis General Hospital, São Paulo, Brazil; Division of Infectious Diseases, University of California San Diego School of Medicine, La Jolla, California

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Juvencio FurtadoDepartment of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious Diseases, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil; Department of Biointeraction, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Infectious Diseases, Heliopolis General Hospital, São Paulo, Brazil; Division of Infectious Diseases, University of California San Diego School of Medicine, La Jolla, California

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Antonio SeguroDepartment of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious Diseases, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil; Department of Biointeraction, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Infectious Diseases, Heliopolis General Hospital, São Paulo, Brazil; Division of Infectious Diseases, University of California San Diego School of Medicine, La Jolla, California

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Joseph M. VinetzDepartment of Nephrology, University of São Paulo School of Medicine, São Paulo, Brazil; Department of Infectious Diseases, Emilio Ribas Institute of Infectious Diseases, São Paulo, Brazil; Department of Biointeraction, Federal University of Bahia, Salvador, Bahia, Brazil; Department of Infectious Diseases, Heliopolis General Hospital, São Paulo, Brazil; Division of Infectious Diseases, University of California San Diego School of Medicine, La Jolla, California

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We report a case of severe hypomagnesemia in non-oliguric acute renal failure caused by leptospirosis that required large doses of magnesium replacement during the acute phase of disease. Biochemical studies confirmed kidney-related magnesium wasting and the mechanisms of this defect are discussed. Magnesium imbalance with its attendant clinical complications occurs in leptospirosis and should be monitored and treated aggressively in cases of leptospirosis-induced non-oliguric acute kidney injury.

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