Department of Internal Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Hosp Med. 2010 Feb;5(2):E18-20. doi: 10.1002/jhm.579.
Historically, the milk-alkali syndrome developed as an adverse reaction to the Sippy regimen of milk, cream and alkaline powders as treatment for peptic ulcer disease. The classic description includes hypercalcemia, metabolic alkalosis, and renal failure. Over the past 20 years, milk-alkali syndrome has had a resurgence, as consumption of supplements containing calcium has increased. A 46-year-old man presented to the emergency department after outpatient labs to evaluate his fatigue. He was found to have acute renal failure and hypercalcemia (total serum calcium was 15.9 mg/dL). Subsequent laboratory evaluation excluded both hyperparathyroidism and malignancy as causes. A detailed history led to the diagnosis of milk-alkali syndrome. With hydration and cessation of calcium carbonate ingestion, his renal function and serum calcium levels returned to normal. Physicians should have a high index of suspicion for milk-alkali syndrome in patients with hypercalcemia. Milk-alkali syndrome is no longer a merely a historical curiosity; it is currently the third most common cause of hypercalcemia.
从历史上看，牛奶-碱中毒综合征是作为治疗消化性溃疡病的 Sippy 方案（牛奶、奶油和碱性粉末）的不良反应而发展起来的。经典描述包括高钙血症、代谢性碱中毒和肾功能衰竭。在过去的 20 年中，随着钙补充剂的消费增加，牛奶-碱中毒综合征再次出现。一名 46 岁的男子因门诊实验室检查评估疲劳而到急诊就诊。他被发现患有急性肾功能衰竭和高钙血症（总血清钙为 15.9mg/dL）。随后的实验室评估排除了甲状旁腺功能亢进和恶性肿瘤作为病因。详细的病史导致了牛奶-碱中毒综合征的诊断。通过水化和停止碳酸钙摄入，他的肾功能和血清钙水平恢复正常。医生应该对高钙血症患者的牛奶-碱中毒综合征保持高度怀疑。牛奶-碱中毒综合征不再仅仅是一个历史上的奇闻轶事；它现在是导致高钙血症的第三大常见原因。
