Two separate trace element issues
Patient with Gitelman's syndrome developed significant hyponatraemia taking spironolactone and was switched to amiloride; both preparations failed to control hypomagnesaemia. Is there a better approach?
Patient had aluminium dental crown fitted and noticed electrical tingling in mouth and unpleasant taste; two weeks later had diarrhoea and other vague symptoms including muscle fatigue; he is a physicist, working in an industrial chemistry company specialising in corrosion, and wondered if he had an electrical cell formed by recent mercury/silver amalgam filling and the aluminium crown, causing electrolysis of aluminium and hence aluminium toxicity. Crown removed four weeks ago, feeling better.
Any help gratefully received.
John Frater
Consultant Chemical Pathologist
University Hospital of Hartlepool