Rennies, Crohn's disease and severe hypercalcaemia.
A 59-year-old lady presented with vomiting and diarrhoea. She was found to have severe hypercalcaemia (5.2 mmol/l) and to be in renal failure. She had a high daily intake of calcium carbonate in the form of Rennies Dual Action, raising the possibility of milk-alkali syndrome. She had ongoing gastrointestinal symptoms after resolution of hypercalcaemia. Further investigation revealed, previously undiagnosed rectal Crohn's disease. Serum 1,25-dihydroxyvitamin D (calcitriol) level was markedly elevated. It is possible that the calcitriol from Crohn's disease tissue facilitated excessive absorption of calcium from the antacid preparation, thus triggering hypercalcaemia.
Department of Medicine, Stirling Royal Infirmary, Livilands, Stirling, UK. filip.zemrak@gmail.com
Filip
F
Zemrak
Lisa
L
McNeil
Norman
N
Peden
D002119:Calcium Carbonate / Q000009:adverse effects*; D003424:Crohn Disease / Q000150:complications*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000139:chemically induced*; D008274:Magnesium / Q000009:adverse effects*; D008875:Middle Aged; D012720:Severity of Illness Index
C099689:Rennie; D002119:Calcium Carbonate; D008274:Magnesium