Milk-alkali syndrome
Definition
- Hypercalcemia due to increased calcium intake in the setting of renal failure
Background
- 3rd most common cause of hypercalcemia, after hyperparathyroidism and malignancy
Clinical Features
- Often due to heavy use of calcium containing antacids
- Headache, confusion, dizziness, poor appetite, psychosis, dry mouth, constipation
Laboratory Evaluation
- High calcium
- Alkalosis
- Normal or high serum phosphate
- Low serum PTH
- Normal serum 25(OH)D
- Normal or low 1,25(OH)D
Management
- Hydration
- Avoidance of calcium / alkali intake
- Hospitalization for IV hydration in severe cases