Milk-alkali syndrome caused by ingestion of antacid tablets

The authors report the case of a 66-year-old man suffering from a milk-alkali syndrome caused by the ingestion of large amounts of antacid tablets. The milk-alkali syndrome is a rare metabolic disorder but remains an important cause of hypercalcaemia. The symptoms of the syndrome are the triad of hypercalcaemia, metabolic alkalosis and renal insufficiency. The primary disorders are the ingestion of an excess of calcium and absorbable alkali as well as their decreased renal excretion. Fully reversible in early stages, it may lead to irreversible complications like chronic renal failure and soft tissue calcification in more advanced stages. The physiopathological mechanism of the syndrome will be reviewed in this report. The association with chronic obstructive pulmonary disease and respiratory acidosis may play a precipitating role.