rennie and Hypercalcemia

Milk alkali syndrome is a cause of hypercalcaemia, renal failure and alkalosis, and is potentially reversible if detected early and the calcium and alkali source withdrawn. It was originally described in patients ingesting large amounts of calcium containing milk for the treatment of peptic ulcer disease. We present a modern day version of the syndrome in three cases which were associated with excessive intake of Rennie, a calcium carbonate containing antacid.

Topics: Aged; Alkalosis; Calcium Carbonate; Causality; Early Diagnosis; Female; Humans; Hypercalcemia; Magnesium; Male; Medical History Taking; Middle Aged; Nonprescription Drugs; Patient Education as Topic; Peptic Ulcer; Renal Insufficiency; Self Medication; Syndrome

A 59-year-old lady presented with vomiting and diarrhoea. She was found to have severe hypercalcaemia (5.2 mmol/l) and to be in renal failure. She had a high daily intake of calcium carbonate in the form of Rennies Dual Action, raising the possibility of milk-alkali syndrome. She had ongoing gastrointestinal symptoms after resolution of hypercalcaemia. Further investigation revealed, previously undiagnosed rectal Crohn's disease. Serum 1,25-dihydroxyvitamin D (calcitriol) level was markedly elevated. It is possible that the calcitriol from Crohn's disease tissue facilitated excessive absorption of calcium from the antacid preparation, thus triggering hypercalcaemia.

Topics: Calcium Carbonate; Crohn Disease; Female; Humans; Hypercalcemia; Magnesium; Middle Aged; Severity of Illness Index