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I agree with Drs Moore and Flink that the magnesium repletion in our patient was probably inadequate. It is certainly likely that his arrhythmias were as much related to hypomagnesemia as to hypokalemia. Dr Flink's point about the dosage of magnesium in deficiency states is important, as is the point of both physicians about the urgency of administering enough magnesium rather than relying on diet, and I agree that Fankushen et al's report does not help either way. This correspondence serves to stress our point that delirium tremens is a potentially dangerous condition, with potential major deficiencies of magnesium and potassium leading to life-threatening arrhythmias.
Abrams J. Magnesium Deficiency as a Cause of Serious Arrhythmias-Reply. Arch Intern Med. 1978;138(5):825-826. doi:10.1001/archinte.1978.03630290105040