Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Milk-alkali syndrome secondary to the intake of calcium supplements

칼슘 제제 복용 후 발생한 우유알칼리증후군

  • Lee, In Hee (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Noh, Sin Young (Department of Internal Medicine, Catholic University of Daegu School of Medicine) ;
  • Kang, Gun Woo (Department of Internal Medicine, Catholic University of Daegu School of Medicine)
  • 이인희 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 노신영 (대구가톨릭대학교 의과대학 내과학교실) ;
  • 강건우 (대구가톨릭대학교 의과대학 내과학교실)
  • Received : 2015.01.27
  • Accepted : 2015.03.20
  • Published : 2016.06.30
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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.

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References

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