Over-the-Counter Drug Causing Acute Pancreatitis

Abstract

Acute pancreatitis is caused by alcohol, gall stone disease, drugs, trauma, infections, and metabolic causes such as hypercalcemia and hyperlipidemia. Hypercalcemia-induced acute pancreatitis has been well documented but only rarely occurs due to over-the-counter calcium carbonate. In this article, we present a case of over-the-counter calcium carbonate–induced acute pancreatitis.

A Case of Milk-Alkali Syndrome Caused by Diuretic-Induced Alkalosis and Polypharmacy

“…Milk-alkali syndrome is suggested to be the third-most-common cause of hypercalcemia requiring hospitalization, with a high proportion of the cases being severe in intensity [16]. There are also previous reports of milk-alkali syndrome complicated by secondary acute pancreatitis [17,18] and acute encephalopathy [19]. Milk-alkali syndrome should be considered a differential diagnosis in patients with hypercalcemia and multiple comorbidities.…”

“…Her main blood test results are presented in Table 1. The results of her urinalysis were as follows: K, 22.2% (10-20); P, 30.0% (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20); Mg, 4.2% (2-3); urinary K/Cr ratio, 25.4 mEq/g•Cr; and urinary Ca excretion, 0.32 mg/dLGF (Table 1). A 12-lead electrocardiogram (ECG) revealed the following findings: heart rate, 59 beats/min; rhythm, sinus rhythm; T wave, flat-low; and QTc, 0.53 s. Computed tomography (CT) without chest enhancement showed no enlarged lymph nodes in the mediastinum or hilar region.…”