Milk-alkali syndrome natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Shakiba Hassanzadeh, MD[2]

Overview

Most patients with milk-alkali syndrome are asymptomatic and may be incidentally diagnosed. Prognosis of milk-alkali syndrome is generally good and early diagnosis and treatment, with withdrawal of the offending agent and supportive therapy, usually resolve the symptoms and abnormalities in milk-alkali syndrome (hypercalcemia, alkalosis and renal insufficiency).

Natural History, Complications, and Prognosis

Natural History

Milk-alkalai syndrome and its features (hypercalcemia, alkalosis, and renal insufficiency) may be incidentally diagnosed since most patients are asymptomatic.

Complications

Complications of milk-alkali syndrome may include:

• Confusion
• Psychosis
• Variable degrees of renal insufficiency
• Pancreatitis
• Reversible cardiac conduction abnormalities
• Tremor

• Metastatic calcification
  • • Ocular calcification in the cornea (keratopathy) and in the conjunctiva (conjunctivitis)
    • Renal calcinosis
    • In less common sites such as central nervous system, lungs, liver, adrenal glands, bone, periarticular and subcutaneous tissue

Prognosis

• Prognosis of milk-alkali syndrome is generally good.
• Early diagnosis and treatment, with withdrawal of the offending agent and supportive therapy, usually resolve the symptoms and abnormalities in milk-alkali syndrome (hypercalcemia, alkalosis and renal insufficiency).