title: Milk alkali syndrome following over-the-counter antacid self-medication.
abstract: Four patients with mild, asymptomatic chronic renal failure became severely hypercalcaemic while taking over-the-counter antacids with daily calcium loads of only 4-8 g. Renal impairment carries an increased liability to this syndrome. Persistent elevation of serum parathyroid hormone levels led to parathyroid exploration in two of the cases, and normal glands were found. In retrospect the hormone levels were appropriate to the degree of renal impairment. Over-the-counter antacid preparations should carry dosage warnings to avoid the possibility of hypercalcaemia.
authors.forename: J K
authors.initials: JK
authors.lastname: French
authors.forename: I M
authors.initials: IM
authors.lastname: Holdaway
authors.forename: L C
authors.initials: LC
authors.lastname: Williams
mesh_terms: D000368:Aged; D000863:Antacids / Q000008:administration & dosage / Q000009:adverse effects*; D002118:Calcium / Q000097:blood; D003404:Creatinine / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced* / Q000175:diagnosis; D006961:Hyperparathyroidism / Q000175:diagnosis; D007676:Kidney Failure, Chronic / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000009:adverse effects*; D010281:Parathyroid Hormone / Q000097:blood; D012651:Self Medication / Q000009:adverse effects*
chemical_list: D000863:Antacids; D004366:Nonprescription Drugs; D010281:Parathyroid Hormone; D003404:Creatinine; D002118:Calcium