Milk-Alkali Syndrome: A Rare But Rising Cause of Hypercalcemia

Milk-alkali syndrome is a condition caused by ingesting an excessive amount of calcium and absorbable alkali. It is described by the triad of elevated blood calcium levels, acute kidney injury, and metabolic alkalosis. While it was historically rare, it is starting to become more common due to the use of over-the-counter calcium-containing medications for the treatment of acid reflux and osteoporosis. We present a case of a 51-year-old male who presented with altered mental status and generalized weakness. He was noted to have severe hypercalcemia and acute kidney injury with a history of recently increasing his calcium carbonate antacid for indigestion. He was appropriately treated with the resolution of hypercalcemia and presenting symptoms. Once considered rare, milk-alkali syndrome is now the third most common cause of hypercalcemia and should be included high in the differential diagnosis of hypercalcemia.