Yeungnam Univ J Med.  2016 Jun;33(1):48-51. 10.12701/yujm.2016.33.1.48.

Milk-alkali syndrome secondary to the intake of calcium supplements

Affiliations
  • 1Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. ihlee@cu.ac.kr

Abstract

Milk-alkali syndrome (MAS), a triad of hypercalcemia, metabolic alkalosis, and renal failure, is associated with ingestion of large amounts of calcium and absorbable alkali. MAS is the third most common cause of hypercalcemia in hospital, after primary hyperparathyroidism and malignant neoplasm. MAS is not often reported in the Korean literature. We describe MAS secondary to intake of calcium citrate for the treatment of osteoporosis with thoracic spine compression fracture. A 70-year-old man presented to our hospital with a 1-week history of general weakness and lethargy. He was found with acute kidney injury (serum creatinine, 4.6 mg/dL), hypercalcemia (total calcium, 14.8 mg/dL), and alkalosis. Laboratory evaluation excluded both hyperparathyroidism and malignancy. Mental status and serum calcium level was normalized within a week after proper hydration and intravenous administration of furosemide. However, he developed aspiration pneumonia, pseudomembranous colitis, and sepsis with multi-organ failure. Despite intensive treatment including inotropics, mechanical ventilation, and renal replacement therapy, he expired with no signs of renal recovery on the 28th hospital day.

Keyword

Hypercalcemia; Alkalosis; Renal insufficiency

MeSH Terms

Acute Kidney Injury
Administration, Intravenous
Aged
Alkalies
Alkalosis
Calcium Citrate
Calcium*
Creatinine
Eating
Enterocolitis, Pseudomembranous
Fractures, Compression
Furosemide
Humans
Hypercalcemia*
Hyperparathyroidism
Hyperparathyroidism, Primary
Lethargy
Osteoporosis
Pneumonia, Aspiration
Renal Insufficiency
Renal Replacement Therapy
Respiration, Artificial
Sepsis
Spine
Alkalies
Calcium
Calcium Citrate
Creatinine
Furosemide
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