Milk-alkali syndrome
Alerts and Notices
Synopsis
Many patients are asymptomatic, or they may present with findings related to hypercalcemia, including nausea, weakness, pruritus, anorexia, fatigue, headache, mental status alteration, myalgia, and insomnia. Laboratory test results may reveal hypophosphatemia and hypomagnesemia.
Therapy is the removal of the source of extra calcium and treatment with non-thiazide diuretics and isotonic saline.
Codes
ICD10CM:E83.52 – Hypercalcemia
SNOMEDCT:
43258006 – Milk alkali syndrome
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
Other conditions that may cause hypercalcemia include:- Hyperthyroidism
- Primary or tertiary hyperparathyroidism
- Ectopic secretion of parathyroid hormone-related peptide by renal cell carcinomas or squamous cell malignancies, most commonly of the lung or head and neck
- Hematologic malignancy
- Familial hypocalciuric hypercalcemia – fractional excretion of calcium will be low
- Hypophosphatasia
- Immobilization – may cause increased bone turnover
- Lithium therapy
- Vitamin D intoxication
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:05/08/2019
Last Updated:05/13/2019
Last Updated:05/13/2019