Milk-alkali syndrome in a patient with postoperative hypoparathyroidism

The milk-alkali syndrome or calcium-alkali syndrome was originally described before almost 80 years in patients treated with large quantities of milk and calcium for the treatment of peptic ulcer disease. The syndrome now is the third leading cause of hypercalcemia behind primary hyperparathyroidism and malignancy, because of the large number of patients who take calcium and vitamin D for the prevention and treatment of osteoporosis. We present a case of milk-alkali syndrome in a patient with postoperative hypoparathyroidism who was on replacement therapy with calcium carbonate and alfa-calcidol and presented with hypercalcemia, renal failure and metabolic alkalosis, which is the hallmark triad of milk-alkali syndrome.