The Milk-Alkali Syndrome, Vitamin D, and Parathyroid Hormone

Dorsch, Thomas R.

doi:10.7326/0003-4819-105-5-800

Cited by 10 publications

(4 citation statements)

References 3 publications

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“…Even with vitamin D supplementation as high as 800 IU/d, 25-hydroxyvitamin D levels have been reported to be normal or even low (13,15) (as reported in patient 1). In the small number of serum calcitriol values reported, 11 were low and four were low normal (13,15,17,18,131) (as reported in patient 2). Therefore, it could be argued that in a minority of patients, the failure to suppress calcitriol levels fully could contribute to the development of the milk alkali syndrome in a setting in which the ingestion of calcium is high.…”

Section: Vitamin Dmentioning

confidence: 99%

“…Another consideration is that many patients with osteoporosis also may receive treatment with vitamin D. Therefore, there is a possibility that high 25-hydroxyvitamin D levels could contribute to a failure to suppress calcitriol values appropriately. At present, there is limited information in the milk alkali syndrome that originated from two small series (13,18) and several case reports (15,17,24) regarding 25-hydroxyvitamin D levels and the suppression of calcitriol. Even with vitamin D supplementation as high as 800 IU/d, 25-hydroxyvitamin D levels have been reported to be normal or even low (13,15) (as reported in patient 1).…”

Section: Vitamin Dmentioning

confidence: 99%

“…At present, there is limited information in the milk alkali syndrome that originated from two small series (13,18) and several case reports (15,17,24) regarding 25-hydroxyvitamin D levels and the suppression of calcitriol. Even with vitamin D supplementation as high as 800 IU/d, 25-hydroxyvitamin D levels have been reported to be normal or even low (13,15) (as reported in patient 1). In the small number of serum calcitriol values reported, 11 were low and four were low normal (13,15,17,18,131) (as reported in patient 2).…”

Section: Vitamin Dmentioning

confidence: 99%

See 2 more Smart Citations

Milk Alkali Syndrome and the Dynamics of Calcium Homeostasis

Felsenfeld¹,

Levine²

2006

Clinical Journal of the American Society of Nephrology

107

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Section: Vitamin Dmentioning

confidence: 99%

Section: Vitamin Dmentioning

confidence: 99%

Section: Vitamin Dmentioning

confidence: 99%

See 1 more Smart Citation

Milk Alkali Syndrome and the Dynamics of Calcium Homeostasis

Felsenfeld¹,

Levine²

2006

Clinical Journal of the American Society of Nephrology

107

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“…After the introduction of Hi block ers has altered the basis of treatment of peptic ulcer, MAS may still occur with the ingestion of a smaller amount of calcium and alkali [1][2][3]. The pathogenesis of MAS has not been fully understood.…”

mentioning

confidence: 99%

Sustained Metabolic Alkalosis Associated with Development of the Milk-Alkali Syndrome

Nakanishi¹,

Uyama²,

Yamada³

et al. 1992

Nephron

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The Milk-Alkali Syndrome

Abreo¹

1993

Arch Intern Med

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The milk-alkali syndrome became rare with the advent of modern ulcer therapy with nonabsorbable antacids, histamine2 blockers, and sucralfate. An increased frequency of this syndrome seems likely with the growing popularity of the use of calcium carbonate as an antacid or as calcium supplementation to prevent osteoporosis. We treated five patients who had six episodes of the milk-alkali syndrome; four of these cases were diagnosed between 1990 and 1992. All patients were ingesting massive quantities of calcium and absorbable alkali and were unaware of the toxic effects of these compounds. All patients presented with the triad of hypercalcemia, metabolic alkalosis, and renal failure. All metabolic abnormalities were corrected, and renal function improved with appropriate supportive measures and cessation of calcium and alkali ingestion. In two patients, the renal failure was so severe that dialysis was necessary. In four patients, either the serum amino-terminal parathyroid hormone or 1,25-dihydroxycholecalciferol levels were appropriately decreased in response to hypercalcemia. The serum carboxy-terminal parathyroid hormone levels were increased because of renal failure. Since both physicians and patients are often unaware of the calcium and alkali content of many nonprescription medicines, the diagnosis of the milk-alkali syndrome, a reversible cause of renal failure, can be missed if a detailed history of such intake is not elicited. Measurement of the serum amino-terminal parathyroid hormone and 1,25-dihydroxycholecalciferol levels may help differentiate milk-alkali syndrome from primary hyperparathyroidism.

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The Milk-Alkali Syndrome, Vitamin D, and Parathyroid Hormone

Cited by 10 publications

References 3 publications

Milk Alkali Syndrome and the Dynamics of Calcium Homeostasis

Milk Alkali Syndrome and the Dynamics of Calcium Homeostasis

Sustained Metabolic Alkalosis Associated with Development of the Milk-Alkali Syndrome

The Milk-Alkali Syndrome

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