Milk-alkali syndrome laboratory findings
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Laboratory Findings
Levels of serum calcium must be obtained, but a full workup must include total/ionized calcium, albumin, phosphate, PTH, PTHrP, vitamin D and TSH. In addition, evaluation of hypercalcemia must include an ECG, which may show a short QT interval.
Overview
Laboratory Findings
- The following laboratory findings are seen in milk-alkali syndrome:[1][2][3]
- Hypercalcemia
- Metabolic alkalosis
- Variable degrees of renal insufficiency
- Phosphorus may be normal or low (phosphorus levels used to be high in the classic milk-alkali syndrome due to the high phosphorus load from cream and milk and the development of acute and chronic renal injury.)
- Vitamin D is usually low, but may be normal or increased if vitamin D supplements are the cause to milk-alkali syndrome. 8
- Parathyroid hormone (PTH) is usually low, but is occasionally normal which may be because of renal insufficiency or a rapid decrease in serum calcium after aggressive therapy with intravenous saline . (7)
- PTH should be checked in order to rule out primary hyperparathyroidism.
References
- ↑ Beall DP, Henslee HB, Webb HR, Scofield RH (2006). "Milk-alkali syndrome: a historical review and description of the modern version of the syndrome". Am J Med Sci. 331 (5): 233–42. doi:10.1097/00000441-200605000-00001. PMID 16702792.
- ↑ Medarov BI (2009). "Milk-alkali syndrome". Mayo Clin Proc. 84 (3): 261–7. doi:10.1016/S0025-6196(11)61144-0. PMC 2664604. PMID 19252114.
- ↑ Kapsner P, Langsdorf L, Marcus R, Kraemer FB, Hoffman AR (1986). "Milk-alkali syndrome in patients treated with calcium carbonate after cardiac transplantation". Arch Intern Med. 146 (10): 1965–8. PMID 3532984.