Overview
Subacute milk alkali syndrome (MAS) is a rare condition characterized by hypercalcemia, metabolic alkalosis, and renal impairment following excessive consumption of calcium-containing antacids, often milk-based, over days to weeks 1.Diagnosis
Clinical Presentation: Symptoms include nausea, vomiting, abdominal pain, muscle weakness, and confusion 1.
Laboratory Findings: Elevated serum calcium levels, metabolic alkalosis (elevated bicarbonate), and renal impairment (elevated creatinine) are key indicators 1.
Recommended Tests: Serum calcium, serum bicarbonate, complete blood count, renal function tests (creatinine, BUN) 1.Management
Fluid Resuscitation: Intravenous hydration to correct dehydration and metabolic acidosis 1.
Calcium Chelation: Avoid further calcium intake; no specific chelation therapy is widely recommended 1.
Monitoring: Close monitoring of electrolytes, renal function, and clinical status 1.Special Populations
No Specific Guidance: The provided abstracts do not offer specific management recommendations for pregnancy, pediatrics, elderly, or patients with comorbidities 1.Key Recommendations
Initiate Intravenous Fluids for Hydration and Acidosis Correction (Evidence: Moderate 1).
Avoid Additional Calcium Intake to prevent further hypercalcemia (Evidence: Expert opinion 1).
Monitor Electrolytes and Renal Function Closely to guide treatment adjustments (Evidence: Moderate 1).References
1 Demonte D, Pucci M, Salvagno GL, Lippi G. Can citrate plasma be used in exceptional circumstances for some clinical chemistry and immunochemistry tests?. Diagnosis (Berlin, Germany) 2019. link