Severe Milk-Alkali Syndrome in a Patient with Hypoparathyroidism Associated with 1,25(OH)2D, Hydrochlorothiazide and Anthranoid Laxative Consumption

Morini, Lorenzo and Donelli, Davide and Santi, Rosaria and Trenti, Chiara and Battaglino, Giuseppe and Iannuzzella, Francesco and Negri, Emanuele Alberto (2017) Severe Milk-Alkali Syndrome in a Patient with Hypoparathyroidism Associated with 1,25(OH)2D, Hydrochlorothiazide and Anthranoid Laxative Consumption. European Journal of Case Reports in Internal Medicine, 4 (10). ISSN 2284-2594

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Abstract

Background: Milk-alkali syndrome is a life-threatening condition defined by the triad of hypercalcaemia, metabolic alkalosis and acute renal failure, and is associated with consumption of calcium and absorbable alkali. Methods: We report the case of a patient admitted to a step-down unit of a large hospital in Italy. Results: The patient was a 59-year-old woman with hypoparathyroidism and mild chronic kidney insufficiency, treated for a preceding episode of hypocalcaemia with high doses of calcitriol and calcium carbonate, who was also taking hydrochlorothiazide and unreported herbal anthranoid laxatives. The patient was admitted to hospital with severe hypercalcaemia, severe metabolic alkalosis and acute renal insufficiency. The patient was successfully treated with urgent dialysis, loop diuretics and calcitonin administration. Conclusions: This case underlines the need for caution when treating patients with impaired calcium metabolism regulation, and suggests that herbal anthranoid laxatives might act as triggers for milk-alkali syndrome..

Item Type: Article
Uncontrolled Keywords: Milk-alkali, Hypoparathyroidism, Hypercalcemia, Alkalosis, Renal Insufficiency, Anthraquinones, Hydrochlorothiazide, Calcitriol
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale)
Depositing User: Chiara D'Arpa
Date Deposited: 26 Jan 2018 09:42
Last Modified: 26 Jan 2018 09:42
URI: http://eprints.bice.rm.cnr.it/id/eprint/17012

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