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== Historical Perspective ==
== Historical Perspective ==
===Eponym===
===Eponym===
It is named for Charles Hoyt Burnett.<ref>{{WhoNamedIt|synd|4029}}</ref><ref>{{cite journal |author=Burnett CH, Commons RR, Albright F, Howard JE |title=Hypercalcemia without hypercalcuria or hypophosphatemia, calcinosis and renal insufficiency; a syndrome following prolonged intake of milk and alkali |journal=N. Engl. J. Med. |volume=240 |issue=20 |pages=787–94 |year=1949 |pmid=18126919 |doi= |url=}}</ref>
It is named for Charles Hoyt Burnett.<ref>{{WhoNamedIt|synd|4029}}</ref><ref name=":0">{{cite journal |author=Burnett CH, Commons RR, Albright F, Howard JE |title=Hypercalcemia without hypercalcuria or hypophosphatemia, calcinosis and renal insufficiency; a syndrome following prolonged intake of milk and alkali |journal=N. Engl. J. Med. |volume=240 |issue=20 |pages=787–94 |year=1949 |pmid=18126919 |doi= |url=}}</ref>
===Discovery===
===Discovery===
* There is limited information about the historical perspective of milk-alkali syndrome.
* There is limited information about the historical perspective of milk-alkali syndrome.
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*Toxic reactions associated with [[alkalosis]] and [[renal insufficiency]] were noted shortly thereafter, but the plasma calcium concentration was not measured.
*Toxic reactions associated with [[alkalosis]] and [[renal insufficiency]] were noted shortly thereafter, but the plasma calcium concentration was not measured.
*In 1936, a report associated hypercalcemia with the alkalosis and renal failure in patients treated with the Sippy regime.<ref name="pmid7891547">{{cite journal |vauthors=Beall DP, Scofield RH |title=Milk-alkali syndrome associated with calcium carbonate consumption. Report of 7 patients with parathyroid hormone levels and an estimate of prevalence among patients hospitalized with hypercalcemia |journal=Medicine (Baltimore) |volume=74 |issue=2 |pages=89–96 |date=March 1995 |pmid=7891547 |doi= |url=}}</ref>
*In 1936, a report associated hypercalcemia with the alkalosis and renal failure in patients treated with the Sippy regime.<ref name="pmid7891547">{{cite journal |vauthors=Beall DP, Scofield RH |title=Milk-alkali syndrome associated with calcium carbonate consumption. Report of 7 patients with parathyroid hormone levels and an estimate of prevalence among patients hospitalized with hypercalcemia |journal=Medicine (Baltimore) |volume=74 |issue=2 |pages=89–96 |date=March 1995 |pmid=7891547 |doi= |url=}}</ref>
<br />
==Overview==
In 1915, Bertram Sippy introduced a treatment for [[Peptic ulcer|peptic ulcer disease]] which was an hourly mixture of milk and cream combined with [[Alkali|alkaline]] powders. In 1923,  the toxic effects of Sippy’s regimen. was reported for the first time. With the introduction of [[Histamine antagonist|histamine antagonists]] and decrease in [[antacid]] consumption since the 1970s, the incidence of milk-alkali syndrome has decreased significantly. However, since the 1990s, there has been an increase in milk-alkali syndrome due to increase in [[calcium]] and [[vitamin D]] consumption in postmenopausal women for [[osteoporosis]] prevention.
== Historical Perspective ==
* In 1915, Bertram Sippy introduced a treatment for [[Peptic ulcer|peptic ulcer disease]] which was an hourly mixture of milk and cream combined with [[Alkali|alkaline]] powders ([[magnesium oxide]], [[sodium bicarbonate]], and bismuth subcarbonate). 4
* In 1923, Hardt and Rivers reported toxic effects of Sippy’s treatment regimen, and reported [[Acute kidney injury|azotemia]] and increase in [[sodium bicarbonate]] in patients that had signs of toxemia ([[Headache|headaches]], [[Nausea and vomiting|nausea, vomiting]], [[dizziness]], and distaste for milk). 5
* In 1936, Cope found [[hypercalcemia]], [[hyperphosphatemia]], [[Acute kidney injury|azotemia]], and increased [[bicarbonate]] in patients on [[alkali]] therapies for gastric ulcers.
* In 1949, Burnett described a syndrome with [[hypercalcemia]] without [[hypercalciuria]] or [[hypophosphatemia]], [[renal insufficiency]] and [[calcinosis]] in patients consuming milk and alkali. The renal insufficiency did not resolve after the withdrawal of the milk and [[alkali]] therapy and most patients progressed to [[Chronic renal failure|chronic renal disease]].<ref name=":0" />
* In 1963, Punsar and Somer classified milk-alkali syndrome into 2 categories: 9
** Cope syndrome (acute) 
** Burnett syndrome (chronic)
* [[H2 antagonist|Histamine-2 blockers]]  and [[Proton pump inhibitor|proton pump inhibitors (PPIs)]] were introduced in in 1976 and 1989, respectively. This has led to a significant decrease in the 'classic' milk-alkali syndrome that mostly affected middle aged men who consumed the 'Sippy Powder' for [[Peptic ulcer|peptic ulcer disease]].
* Since the 1990s, there has been an increase in the 'modern' milk-alkali syndrome due to increase in [[calcium]] and [[vitamin D]] consumption in postmenopausal women for [[osteoporosis]] prevention.
==References==
==References==
{{reflist|2}}
{{reflist|2}}

Revision as of 08:09, 15 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Eponym

It is named for Charles Hoyt Burnett.[1][2]

Discovery

  • There is limited information about the historical perspective of milk-alkali syndrome.
  • In 1915, Sippy designed an antacid regimen to neutralize gastric acidity and promote the healing of peptic ulcer disease .
  • The regimen included the hourly administration of milk or cream with Sippy powders (a powder containing 600 mg of magnesium carbonate and 600 mg sodium bicarbonate alternating with a powder containing 600 mg of bismuth subcarbonate and 1200 to 1800 mg of sodium bicarbonate)
  • Toxic reactions associated with alkalosis and renal insufficiency were noted shortly thereafter, but the plasma calcium concentration was not measured.
  • In 1936, a report associated hypercalcemia with the alkalosis and renal failure in patients treated with the Sippy regime.[3]



Overview

In 1915, Bertram Sippy introduced a treatment for peptic ulcer disease which was an hourly mixture of milk and cream combined with alkaline powders. In 1923, the toxic effects of Sippy’s regimen. was reported for the first time. With the introduction of histamine antagonists and decrease in antacid consumption since the 1970s, the incidence of milk-alkali syndrome has decreased significantly. However, since the 1990s, there has been an increase in milk-alkali syndrome due to increase in calcium and vitamin D consumption in postmenopausal women for osteoporosis prevention.

Historical Perspective

References

  1. Template:WhoNamedIt
  2. 2.0 2.1 Burnett CH, Commons RR, Albright F, Howard JE (1949). "Hypercalcemia without hypercalcuria or hypophosphatemia, calcinosis and renal insufficiency; a syndrome following prolonged intake of milk and alkali". N. Engl. J. Med. 240 (20): 787–94. PMID 18126919.
  3. Beall DP, Scofield RH (March 1995). "Milk-alkali syndrome associated with calcium carbonate consumption. Report of 7 patients with parathyroid hormone levels and an estimate of prevalence among patients hospitalized with hypercalcemia". Medicine (Baltimore). 74 (2): 89–96. PMID 7891547.

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