Milk-alkali syndrome. A consequence of chronic antacid abuse

The case described here illustrates the need to consider milk-alkali syndrome in the differential diagnosis of hypercalcemia, even in this age of histamine2 blockers and mucosal protectors. Thorough history taking and gastrointestinal workup help rule out alternative causes of hypercalcemia, such as cancer, hyperparathyroidism, and other metabolic and endocrine diseases. Milk-alkali syndrome is managed by administration of saline solution and loop diuretics and avoidance of thiazide diuretics. Patient education regarding the hazards of abusing calcium-containing antacids is essential.