What Happens When Milk-alkali Syndrome Is Misdiagnosed?


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While we usually consider calcium to be a good thing, and many people take calcium supplements regularly to strengthen their bones, consuming too much calcium can cause a whole host of problems. In some cases, high calcium levels can cause permanent harm or death if not identified and treated soon enough.

What Is Milk-alkali Syndrome?

Milk-alkali syndrome gets its strange name from how ulcers were treated before modern medicine took over – with large quantities of milk and alkaline products like sodium bicarbonate (baking soda). Many ulcer patients went on to experience signs of calcium and alkali toxicity. Some cases were mild, and the patients made a full recovery after stopping treatment, but other patients went on to develop kidney failure, and many died. When the true cause of ulcers was understood, and better treatments were developed, milk-alkali syndrome began to disappear.

All of this changed with the emphasis on calcium supplements to reduce the risk of osteoporosis. Suddenly, patients were consuming vast quantities of calcium once again, and milk-alkali syndrome made a resurgence. In recent years, many medical professionals are straying from the original name of this condition and using the term “calcium-alkali syndrome,” as it more accurately reflects the current cause. Common sources of calcium that can contribute to the development of milk-alkali syndrome include dairy products, multivitamins, dietary calcium supplements, and antacids.

Milk-alkali syndrome is the third most common cause of hospitalization due to elevated calcium levels after hyperparathyroidism (a type of hormone imbalance) and cancer. Where previously this condition was mostly observed in men with ulcers, those at greatest risk of developing milk-alkali syndrome now tend to be pregnant or postmenopausal women and the elderly.

Symptoms of milk-alkali syndrome in its early stages include:

  • high urine output
  • headache and confusion
  • fatigue
  • nausea and vomiting
  • dry mouth
  • abdominal pain

In its later stages, if calcium continues to be consumed, symptoms can include:

  • muscle pain
  • psychosis
  • tremor
  • intense thirst
  • itching
  • abnormal calcium deposits throughout the body, including kidney stones
  • kidney damage
  • metabolic alkalosis
  • stroke
  • death

How Is It Diagnosed?

When the symptoms of milk-alkali syndrome are detected, determining how much calcium is being consumed from all sources is helpful. A simple blood test can determine calcium levels in the blood.  In order to determine a more accurate level of the serum creatinine in the blood, your doctor may also order an albumin test, as albumin binds to calcium. 

How Is It Treated?

Patients with asymptomatic or mildly symptomatic (eg, constipation) hypercalcemia (calcium <12 mg/dL [3 mmol/L]) do not require immediate treatment though they should be monitored closely for any acute rise in calcium levels. Patients with a serum calcium of 12 to 14 mg/dL (3 to 3.5 mmol/L) may not require immediate treatment because that degree of hypercalcemia may be well tolerated chronically.

However, an acute rise to these concentrations may cause marked changes in sensorium, which requires a more 'disease-specific approach.' Patients with a serum calcium concentration >14 mg/dL (3.5 mmol/L) require more aggressive treatment, regardless of symptoms.

The emergent treatment for hypercalcemia above 14 mg/dl is the restriction of all exogenous calcium, a calcium-restricted diet, IV saline, zoledronic acid, calcitonin, and/or bisphosphonates. A calcium level above 14 is a medical emergency, regardless of the cause of the hypercalcemia.

For hypercalcemia below the critical level of 14 mg/dl, the appropriate treatment is also the restriction of all exogenous calcium, a calcium-restricted diet, and serial calcium testing every 6-12 hours to monitor the expected decrease.

What Can Happen If It’s Not Treated Appropriately?

When left untreated, milk-alkali syndrome can cause calcium to be abnormally deposited throughout the body, leading to kidney failure, heart attack, stroke, coma, or death. Because of this, medical professionals must assess all patients who consume high amounts of calcium and present with symptoms of this syndrome.

Certain medications can also contribute to the development of milk-alkali syndrome, including certain blood pressure medications and NSAIDs (like ibuprofen and naproxen). Taking OTC antacids, such as aluminum hydroxide, magnesium hydroxide, and calcium carbonate (Tums) can also contribute to milk-alkali syndrome in those who already consume large amounts of calcium.

What Can I Do If Milk-alkali Syndrome Caused A Loved One’s Catastrophic Injury Or Death?

If you believe milk-alkali syndrome played a role in your or a loved one’s catastrophic injury, getting a second opinion is critical to determine if the problem should have been detected sooner or treated more effectively. If your doctor acted negligently and ignored current medical practices, you may be entitled to compensation for medical expenses, pain, and suffering that you and your family have endured.

In addition, you may also be a victim of medical malpractice if a healthcare professional instructed you to take an excessively high dosage of calcium, particularly if you are at high risk for milk-alkali syndrome (such as pre-existing kidney disease or already elevated calcium levels). Such overdoses of calcium can contribute to the development of milk-alkali syndrome, and medical professionals should be held accountable for any harm their negligent prescribing causes.

Why Choose Ross Feller Casey?

The legal team at Ross Feller Casey knows what it takes to win medical malpractice cases, including those involving the potentially catastrophic results of a severe milk-alkali syndrome diagnosis. We’ve recovered billions for our clients and are ready to put our experience to work for you. Our lawyers and Ivy League-trained doctors will work together to get to the bottom of your case. We’ll do everything we can to make those responsible for your personal injury pay for their negligence.

You deserve to move on with your life; we’re ready to help. Consultations are free, and there’s no fee unless you win. Contact us today.

About the Author

Scott Vezina concentrates his practice on representing individuals who have suffered catastrophic brain or spinal cord injuries caused by medical negligence and product defects.

Scott Vezina

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