Milk alkali syndrome induced by calcitriol and calcium bicarbonate in a patient with hypoparathyroidism
A 56-year-old male patient was consulted in our polyclinic with a 1 week history of fatigue and general weakness. In medical history, he had been taking calcium carbonate (3.0 g/daily) and calcitriol (1 μg/daily) for idiopathic hypoparathyroidism for 5 years. In his physical examination, pulse rate was 70/min and blood pressure was 130/75 mmHg. Patient's general physical status was well and pathological finding was not found on physical exam. Urinalysis was normal. The pertinent laboratory tests revealed severe hypercalcemia, acute kidney injury and metabolic alkalosis []. Calcium carbonate and vitamin D treatment were stopped. Intravenous normal saline was administered. After 3 days, his symptoms such as fatigue and weakness resolved and serum levels of calcium, blood urea nitrogen and creatinine regressed.