Toxic Manifestations Following the Alkaline Treatment of Peptic Ulcer

Hardt, Leo L.; Rivers, Andrew B.

doi:10.1001/archinte.1923.00110140023003

Cited by 156 publications

(42 citation statements)

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“…4 In 1936 Cope reported that treatment of peptic ulcer disease was associated with hypercalcemia, renal failure, and alkalosis, establishing the milk-alkali syndrome. 1 After the advent of nonabsorbable antacids, histamine-2 blockers, and proton pump inhibitors, the incidence of milk-alkali syndrome decreased significantly.…”

Section: Discussionmentioning

confidence: 99%

Hypercalcemia in Pregnancy: A Case of Milk-Alkali Syndrome

et al. 2011

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Milk-alkali syndrome is a rare cause of hypercalcemia characterized by the triad of hypercalcemia, renal insufficiency, and metabolic alkalosis that results from the overconsumption of calcium containing products. In the setting of pregnancy where there is a physiologic increase in calcium absorption, milkalkali syndrome can be potentially life threatening. We report a case of a 26-year-old woman in her second trimester of pregnancy who presented with 2 weeks of flank pain, nausea, vomiting, anorexia, headache, and lightheadedness. The history revealed consumption of a large quantity of milk, calcium carbonate antacid, and calcium-containing prenatal vitamins. Her symptoms and hypercalcemia resolved with intravenous fluids and a loop diuretic. With the increased use of calcium carbonate for peptic ulcer disease, gastroesophageal reflux disease, and osteoporosis, milk-alkali syndrome has experienced a resurgence and must be considered in the differential diagnosis of hypercalcemia. In this clinical vignette we review the literature on milk-alkali syndrome in pregnancy and discuss important diagnostic and therapeutic considerations when managing the pregnant patient with hypercalcemia.KEY WORDS: hypercalcemia; milk-alkali syndrome; pregnancy. J Gen Intern Med 26(8):

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Section: Discussionmentioning

confidence: 99%

Hypercalcemia in Pregnancy: A Case of Milk-Alkali Syndrome

et al. 2011

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“…Hardt and Rivers (12) stated that of a group of 48 patients on alkaline therapy for peptic ulcer, approximately one-third showed toxemia with an increase in the blood urea nitrogen and the carbon dioxide combining power. Palmer (13) feels that this is due to the absorption of sodium bicarbonate, the loss of gastric chloride and/or a combination of both.…”

Section: Discussionmentioning

confidence: 99%

A Study of the Effect of an Anion Exchange Resin on Gastric and Duodenal Secretions and Gastric Emptying 1

Wirts¹,

Rehfuss²,

Delserone³

et al. 1950

J. Clin. Invest.

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“…In 1923, Hardt and Rivers provided a detailed description of the toxicity that was associated with the antacid and milk regimen (5). It consisted of headache, nausea, vomiting, dizziness, musculoskeletal pains, and weakness followed by prostration.…”

Section: History Of the Milk Alkali Syndromementioning

confidence: 99%