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The milk-alkali syndrome. A case report
Summary
Milk-alkali syndrome can occur with high calcium levels but normal calcium excretion. This case highlights a patient with elevated serum calcium, azotaemia, and nephrocalcinosis due to calcium carbonate antacids.
Area of Science:
- Nephrology
- Endocrinology
- Gastroenterology
Background:
- Milk-alkali syndrome is a rare condition characterized by hypercalcemia, metabolic alkalosis, and renal insufficiency.
- It is typically associated with excessive intake of calcium and absorbable alkali.
Observation:
- A case is presented of a patient with milk-alkali syndrome.
- The patient exhibited hypercalcemia without hypercalciuria, alongside nephrocalcinosis and azotaemia.
- The causative agent identified was an antacid preparation containing calcium carbonate.
Findings:
- The clinical presentation demonstrated a variant of milk-alkali syndrome with preserved urinary calcium excretion.
- Renal impairment (azotaemia) and calcium deposition in the kidneys (nephrocalcinosis) were significant findings.
- The syndrome was directly linked to the ingestion of calcium carbonate-based antacids.
Implications:
- This case underscores the importance of considering calcium carbonate antacids as a potential cause of milk-alkali syndrome, even with atypical presentations.
- It highlights the need for vigilant diagnosis and management to prevent severe renal complications.
- Clinicians should be aware of the varied clinical manifestations of milk-alkali syndrome and its association with over-the-counter medications.