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Milk-alkali syndrome
From WikEM
Contents
Background
- Definition: Hypercalcemia due to increased calcium intake in the setting of renal failure
- 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
Differential Diagnosis
Causes of Hypercalcemia
- Hypercalcemia of malignancy
- Hyperparathyroidism
- Lithium
- Thiazides
- Hypothyroidism
- Addison's
- Paget's
- Sarcoid
- Hyperthyroid
- Milk-alkali syndrome
- Excess vitamin D
- Calciphylaxis
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
Disposition
- Hospitalization for IV hydration in severe cases
