Milk-alkali syndrome classification

Classification

Milk- alkali syndrome may be classified as

Acute or toxemic form

• The acute or toxemic form occurred after approximately one week of treatment
• The symptoms are acute hypercalcemia
• Nausea and vomiting
• weakness
• Mental changes with psychosis
• Depressed sensorium
• Severe metabolic alkalosis
• Normal to elevated plasma phosphate concentration
• Acute renal insufficiency
• Withdrawal of milk and alkali led to rapid relief of symptoms and the return of normal renal function.

Subacute or Cope's syndrome

• Patients were usually seen during therapy with milk and alkali that had been taken intermittently for years.
• Affected patients had symptoms of both acute and chronic hypercalcemia and responded to medication withdrawal with gradual improvement. Renal function remained mildly impaired in some cases.

Chronic or Burnett's syndrome

• Long history of high milk-alkali intake with symptoms of chronic hypercalcemia such as
• Polyuria
• polydipsia
• Muscle aches, and pruritus
• Evidence of metastatic calcifications, including band keratopathy and nephrocalcinosis
• Laboratory abnormalities were similar to those in the acute syndrome, but the response to withdrawal of milk and alkali was quite different
• The muscle aches and pruritus improved slowly as the plasma calcium concentration slowly normalized
• There is usually minimal or no improvement in renal function, as many patients continued to have chronic renal failure.

==References==