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=== X-ray ===
=== X-ray ===
[[X-rays|X-ray]] is not useful in diagnosis of milk-alkali syndrome. However, [[X-rays|X-ray]] may be useful in excluding other causes of [[hypercalcemia]]. [[Kidney|Renal]] calcium deposits are not seen on [[X-rays|X-ray]] in milk-alkali syndrome.
[[X-rays|X-ray]] is not useful in diagnosis of milk-alkali syndrome. However, [[X-rays|X-ray]] may be useful in excluding other causes of [[hypercalcemia]]. [[Kidney|Renal]] calcium deposits are not seen on [[X-rays|X-ray]] in milk-alkali syndrome.<ref name="pmid19252114">{{cite journal| author=Medarov BI| title=Milk-alkali syndrome. | journal=Mayo Clin Proc | year= 2009 | volume= 84 | issue= 3 | pages= 261-7 | pmid=19252114 | doi=10.1016/S0025-6196(11)61144-0 | pmc=2664604 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19252114  }} </ref>


=== Echocardiography and Ultrasound ===
=== Echocardiography and Ultrasound ===

Revision as of 16:15, 13 July 2020

Milk-alkali syndrome Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: {SHA}}

Overview

Milk-alkali syndrome, also called Burnett's syndrome in honour of the American physician who first described it, is characterized by hypercalcemia caused by repeated ingestion of calcium and absorbable alkali (such as calcium carbonate, or milk and sodium bicarbonate). If untreated, milk-alkali syndrome may lead to metastatic calcification and renal failure.

It was most common in the early 20th century, but there has been a recent increase in the number of cases reported.[1][2]


Overview

Historical Perspective

Pathopysiology

Causes

Differentiating Analgesic nephropathy from other Diseases

Risk Factors

Screening

Natural History, Complications and Prognosis

Epidemiology and Demographics

Diagnosis

Diagnostic Study of Choice

Diagnostic Study of Choice

Milk-alkali syndrome is diagnosed by history of excessive calcium consumption, hypercalcemia, metabolic alkalosis and variable degrees of renal insufficiency. [3]

History and Symptoms

Symptoms of milk-alkali syndrome may inculde: dizziness, vertigo, confusion, apathy, nausea, vomiting, anorexia, distaste for milk, headache, anorexia, pruritus, polydipsia, polyuria, muscle aches, tremor, psychosis, and abnormal calcifications (keratopathy, renal calcinosis).[4][5]

Physical Examination

The following should be considered in the physical examination of milk-alkali syndrome: vertigo, confusion, apathy, nausea, vomiting, anorexia, pruritus, polydipsia, polyuria, muscle aches, tremor, psychosis, and abnormal calcifications (keratopathy, renal calcinosis).[4][5][3]

Laboratory Findings

The following laboratory findings are usually seen in milk-alkali syndrome: hypercalcemia, metabolic alkalosis, variable degrees of renal insufficiency, low or normal phosphorus, low Vitamin D, and low PTH.[2][3][6][7]

Electrocardiogram

X-ray

X-ray is not useful in diagnosis of milk-alkali syndrome. However, X-ray may be useful in excluding other causes of hypercalcemia. Renal calcium deposits are not seen on X-ray in milk-alkali syndrome.[3]

Echocardiography and Ultrasound

Echocardiography is not useful in diagnosis of milk-alkali syndrome. Ultrasound is not useful in diagnosis of milk-alkali syndrome. However, ultrasound may be helpful in excluding other causes of hypercalcemia.

CT Scan

CT scan is not useful in diagnosis of milk-alkali syndrome. However, CT scan may be helpful in excluding other causes of hypercalcemia.

MRI

MRI is not useful in diagnosis of milk-alkali syndrome. However, MRI may be helpful in excluding other causes of hypercalcemia.

Other Imaging Findings

There are no other imaging findings associated with milk-alkali syndrome.

Other Diagnostic studies

There are no other diagnostic studies associated with milk-alkali syndrome.

Treatment

Medical therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

References

  1. Caruso JB, Patel RM, Julka K, Parish DC (2007). "Health-behavior induced disease: return of the milk-alkali syndrome". J Gen Intern Med. 22 (7): 1053–5. doi:10.1007/s11606-007-0226-0. PMID 17483976. Unknown parameter |month= ignored (help)
  2. 2.0 2.1 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. PMID 16702792. Unknown parameter |month= ignored (help)
  3. 3.0 3.1 3.2 3.3 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.
  4. 4.0 4.1 Orwoll ES (1982). "The milk-alkali syndrome: current concepts". Ann Intern Med. 97 (2): 242–8. doi:10.7326/0003-4819-97-2-242. PMID 7049033.
  5. 5.0 5.1 Texter EC, Laureta HC (1966). "The milk-alkali syndrome". Am J Dig Dis. 11 (5): 413–8. doi:10.1007/BF02233637. PMID 5327389.
  6. 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.
  7. Arroyo M, Fenves AZ, Emmett M (2013). "The calcium-alkali syndrome". Proc (Bayl Univ Med Cent). 26 (2): 179–81. doi:10.1080/08998280.2013.11928954. PMC 3603742. PMID 23543983.

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