Milk-alkali syndrome classification: Difference between revisions
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*Laboratory abnormalities were similar to those in the acute syndrome, but the response to withdrawal of milk and alkali was quite different | *Laboratory abnormalities were similar to those in the acute syndrome, but the response to withdrawal of milk and alkali was quite different | ||
*The muscle aches and pruritus improved slowly as the plasma calcium concentration slowly normalized | *The muscle aches and pruritus improved slowly as the plasma calcium concentration slowly normalized | ||
*There is usually minimal or no improvement in renal function, as many patients continued to have chronic renal failure.<ref name="pmid18126919">{{cite journal |vauthors=BURNETT CH, COMMONS RR |title=Hypercalcemia without hypercalcuria or hypophosphatemia, calcinosis and renal insufficiency; a syndrome following prolonged intake of milk and alkali |journal=N. Engl. J. Med. |volume=240 |issue=20 |pages=787–94 |date=May 1949 |pmid=18126919 |doi=10.1056/NEJM194905192402001 |url=}}</ref> | *There is usually minimal or no improvement in renal function, as many patients continued to have chronic renal failure.<ref name="pmid18126919">{{cite journal |vauthors=BURNETT CH, COMMONS RR |title=Hypercalcemia without hypercalcuria or hypophosphatemia, calcinosis and renal insufficiency; a syndrome following prolonged intake of milk and alkali |journal=N. Engl. J. Med. |volume=240 |issue=20 |pages=787–94 |date=May 1949 |pmid=18126919 |doi=10.1056/NEJM194905192402001 |url=}}</ref><ref name="pmid16268810">{{cite journal |vauthors=Picolos MK, Lavis VR, Orlander PR |title=Milk-alkali syndrome is a major cause of hypercalcaemia among non-end-stage renal disease (non-ESRD) inpatients |journal=Clin. Endocrinol. (Oxf) |volume=63 |issue=5 |pages=566–76 |date=November 2005 |pmid=16268810 |doi=10.1111/j.1365-2265.2005.02383.x |url=}}</ref> | ||
<nowiki>==References==</nowiki> | |||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}} | {{WH}} |
Revision as of 16:51, 21 April 2019
Classification
Milk- alkali syndrome may be classified as
Acute or toxemic form
- The acute or toxemic form occurred after approximately one week of treatment
- The symptoms are acute hypercalcemia
- Nausea and vomiting
- weakness
- Mental changes with psychosis
- Depressed sensorium
- Severe metabolic alkalosis
- Normal to elevated plasma phosphate concentration
- Acute renal insufficiency
- Withdrawal of milk and alkali led to rapid relief of symptoms and the return of normal renal function.
Subacute or Cope's syndrome
- Patients were usually seen during therapy with milk and alkali that had been taken intermittently for years.
- Affected patients had symptoms of both acute and chronic hypercalcemia and responded to medication withdrawal with gradual improvement. Renal function remained mildly impaired in some cases.
Chronic or Burnett's syndrome
- Long history of high milk-alkali intake with symptoms of chronic hypercalcemia such as
- Polyuria
- polydipsia
- Muscle aches, and pruritus
- Evidence of metastatic calcifications, including band keratopathy and nephrocalcinosis
- Laboratory abnormalities were similar to those in the acute syndrome, but the response to withdrawal of milk and alkali was quite different
- The muscle aches and pruritus improved slowly as the plasma calcium concentration slowly normalized
- There is usually minimal or no improvement in renal function, as many patients continued to have chronic renal failure.[1][2]
==References==
- ↑ BURNETT CH, COMMONS RR (May 1949). "Hypercalcemia without hypercalcuria or hypophosphatemia, calcinosis and renal insufficiency; a syndrome following prolonged intake of milk and alkali". N. Engl. J. Med. 240 (20): 787–94. doi:10.1056/NEJM194905192402001. PMID 18126919.
- ↑ Picolos MK, Lavis VR, Orlander PR (November 2005). "Milk-alkali syndrome is a major cause of hypercalcaemia among non-end-stage renal disease (non-ESRD) inpatients". Clin. Endocrinol. (Oxf). 63 (5): 566–76. doi:10.1111/j.1365-2265.2005.02383.x. PMID 16268810.