Stoney Ben, Bagchi Gautam
Acute Medical Unit, Russells Hall Hospital, Dudley, UK.
BMJ Case Rep. 2017 May 3;2017:bcr-2017-219611. doi: 10.1136/bcr-2017-219611.
We discuss a case of an 81-year-old man who presented to hospital with a case of severe hypercalcaemia (5.07 mmol/L). The two most common causes of hypercalcaemia, making up around 90% of the cases, are malignancy and primary hyperparathyroidism. Initial investigations are guided by this knowledge. In this case, no underlying malignancy or evidence of a parathyroid adenoma causing primary hyperparathyroidism was found. Instead, on further history, it was found that this patient had troublesome dyspepsia symptoms for which he had ingested 10-12 calcium carbonate tablets a day for the preceding 2 years. This amounts to 6.6-7.9 g of calcium carbonate per day compared with the guideline daily intake of calcium of 1 g. His presentation of severe hypercalcaemia was therefore diagnosed as milk-alkali syndrome secondary to calcium carbonate tablet abuse.
我们讨论一例81岁男性患者，其因严重高钙血症（5.07 mmol/L）入院。高钙血症最常见的两种病因约占病例总数的90%，即恶性肿瘤和原发性甲状旁腺功能亢进。初始检查即基于这一认识进行。在该病例中，未发现潜在的恶性肿瘤或导致原发性甲状旁腺功能亢进的甲状旁腺腺瘤证据。相反，经进一步询问病史发现，该患者有令人困扰的消化不良症状，在之前的两年里，他每天服用10 - 12片碳酸钙片。与每日钙摄入量指南1克相比，这相当于每天摄入6.6 - 7.9克碳酸钙。因此，他的严重高钙血症表现被诊断为因滥用碳酸钙片继发的乳碱综合征。
