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Yeungnam Univ J Med > Volume 33(1); 2016 > Article
Yeungnam University Journal of Medicine 2016;33(1):48-51.
DOI: https://doi.org/10.12701/yujm.2016.33.1.48    Published online June 30, 2016.
Milk-alkali syndrome secondary to the intake of calcium supplements.
In Hee Lee, Sin Young Noh, Gun Woo Kang
Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. ihlee@cu.ac.kr
Abstract
Milk-alkali syndrome (MAS), a triad of hypercalcemia, metabolic alkalosis, and renal failure, is associated with ingestion of large amounts of calcium and absorbable alkali. MAS is the third most common cause of hypercalcemia in hospital, after primary hyperparathyroidism and malignant neoplasm. MAS is not often reported in the Korean literature. We describe MAS secondary to intake of calcium citrate for the treatment of osteoporosis with thoracic spine compression fracture. A 70-year-old man presented to our hospital with a 1-week history of general weakness and lethargy. He was found with acute kidney injury (serum creatinine, 4.6 mg/dL), hypercalcemia (total calcium, 14.8 mg/dL), and alkalosis. Laboratory evaluation excluded both hyperparathyroidism and malignancy. Mental status and serum calcium level was normalized within a week after proper hydration and intravenous administration of furosemide. However, he developed aspiration pneumonia, pseudomembranous colitis, and sepsis with multi-organ failure. Despite intensive treatment including inotropics, mechanical ventilation, and renal replacement therapy, he expired with no signs of renal recovery on the 28th hospital day.
Key Words: Hypercalcemia, Alkalosis, Renal insufficiency
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