Reversible metastatic calcification associated with excessive milk and alkali intake

Wermer, Paul; Kuschner, Marvin; Riley, Edgar Alsop

doi:10.1016/0002-9343(53)90362-3

Cited by 52 publications

(5 citation statements)

References 10 publications

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“…Metastatic pulmonary calcification is further subdivided into benign (4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15) and malignant causes (16)(17)(18)(19)(20)(21) (Table 1). By far the most common cause of metastatic calcification is seen in patients on hemodialysis for chronic renal insufficiency.…”

Section: Clinical Classification Of Pulmonary Calcification and Ossifmentioning

confidence: 99%

Calcium Deposition with or without Bone Formation in the Lung

Chan

Morales

Welsh

et al. 2002

Am J Respir Crit Care Med

333

370

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Pulmonary calcification and ossification occurs with a number of systemic and pulmonary conditions. Specific symptoms are often lacking, but calcification may be a marker of disease severity and its chronicity. Pathophysiologic states predisposing to pulmonary calcification and ossification include hypercalcemia, a local alkaline environment, and previous lung injury. Factors such as enhanced alkaline phosphatase activity, active angiogenesis, and mitogenic effects of growth factors may also contribute. The clinical classification of pulmonary calcification includes both metastatic calcification, in which calcium deposits in previously normal lung or dystrophic calcification, which occurs in previously injured lung. Pulmonary ossification can be idiopathic or can result from a variety of underlying pulmonary, cardiac, or extracardiopulmonary disorders. The diagnosis of pulmonary calcification and ossification requires various imaging techniques, including chest radiography, computed tomographic scanning, and bone scintigraphy. Interpretation of the presence of and the specific pattern of calcification or ossification may obviate the need for invasive biopsy. In this review, specific conditions causing pulmonary calcification or ossification that may impact diagnostic and treatment decisions are highlighted. These include metastatic calcification caused by chronic renal failure and orthotopic liver transplantation, dystrophic calcification caused by granulomatous disorders, DNA viruses, parasitic infections, pulmonary amyloidosis, vascular calcification, the idiopathic disorder pulmonary alveolar microlithiasis, and various forms of pulmonary ossification.

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Section: Clinical Classification Of Pulmonary Calcification and Ossifmentioning

confidence: 99%

Calcium Deposition with or without Bone Formation in the Lung

Chan

Morales

Welsh

et al. 2002

Am J Respir Crit Care Med

333

370

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“…Burnett and Commons [15] reported nephrocalcinosis from a single autopsy. Other autopsy reports described parietal to complete glomerulus hyalinization, thickening of Bowman's capsule, tubular atrophy and diffuse lymphocytic infiltration [16][17][18]. Extensive calcification of convoluted renal tubular cells and the tubular lamina was described as a striking feature [11].…”

Section: Renal Outcomementioning

confidence: 96%

Renal Injury in Calcium-Alkali Syndrome

Morishita¹

2012

J Nephrol Therapeutic

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Calcium-alkali syndrome is characterized by hypercalcemia, renal injury and metabolic alkalosis. Calcium-alkali syndrome caused by calcium carbonate and vitamin D has been increasing in association with their growing use for the treatment and prevention of osteoporosis. Renal injury is the most critical factor determining the severity and prognosis of this syndrome. This review focuses on the mechanism and clinical aspects of renal injury in calcium-alkali syndrome.

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“…Other autopsy reports described partial to complete glomerulus hyalinization, thickening of the Bowman capsule, tubular atrophy, vascular changes, and diffuse lymphocytic infiltration. [68][69][70] Extensive calcification of convoluted renal tubular cells and the tubular lamina was described as a striking feature. 68 Scholz and Keating 10 reported a case of focal calcification in the renal tubules that was apparent on a kidney biopsy specimen from a patient with MAS.…”

Section: Histologic Findingsmentioning

confidence: 99%

“…[68][69][70] Extensive calcification of convoluted renal tubular cells and the tubular lamina was described as a striking feature. 68 Scholz and Keating 10 reported a case of focal calcification in the renal tubules that was apparent on a kidney biopsy specimen from a patient with MAS. Randall et al 71 reported findings on kidney biopsy specimens from 2 patients.…”

Section: Histologic Findingsmentioning

confidence: 99%

Milk-Alkali Syndrome

Medarov

2009

Mayo Clinic Proceedings

108

113

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Milk-alkali syndrome (MAS) consists of hypercalcemia, various degrees of renal failure, and metabolic alkalosis due to ingestion of large amounts of calcium and absorbable alkali. This syndrome was first identified after medical treatment of peptic ulcer disease with milk and alkali was widely adopted at the beginning of the 20th century. With the introduction of histamine2 blockers and proton pump inhibitors, the occurrence of MAS became rare; however, a resurgence of MAS has been witnessed because of the wide availability and increasing use of calcium carbonate, mostly for osteoporosis prevention. The aim of this review was to determine the incidence, pathogenesis, histologic findings, diagnosis, and clinical course of MAS. A MEDLINE search was performed with the keyword milk-alkali syndrome using the PubMed search engine. All relevant English language articles were reviewed. The exact pathomechanism of MAS remains uncertain, but a unique interplay between hypercalcemia and alkalosis in the kidneys seems to lead to a self-reinforcing cycle, resulting in the clinical picture of MAS. Treatment is supportive and involves hydration and withdrawal of the offending agents. Physicians and the public need to be aware of the potential adverse effects of ingesting excessive amounts of calcium carbonate.

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Reversible metastatic calcification associated with excessive milk and alkali intake

Cited by 52 publications

References 10 publications

Calcium Deposition with or without Bone Formation in the Lung

Calcium Deposition with or without Bone Formation in the Lung

Renal Injury in Calcium-Alkali Syndrome

Milk-Alkali Syndrome

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