A Case of Milk Alkali Syndrome: The Forgotten Diagnosis of Generalized Weakness and Altered Consciousness

Authors

  • Md Sabbir Hossain Resident Phase B Bangabandhu Sheikh Mujib Medical University, Shahbag.
  • Md Abul Kalam Azad Professor and Chairman, Internal Medicine Bangabandhu Sheikh Mujib Medical University,Shahbag,Dhaka.
  • Mohammad Ferdous Ur Rahaman Professor ,Geriatric Medicine Bangabandhu Sheikh Mujib Medical University,Shahbag,Dhaka
  • Kazi Ali Aftab Assistant Professor,Internal Medicine Bangabandhu Sheikh Mujib Medical University,Shahbag,Dhaka
  • Imrul Basher Rahman Phase B Resident ,Internal Medicine Bangabandhu Sheikh Mujib Medical University,Shahbag,Dhaka
  • Shirajum Monira Assistant professor, Internal Medicine, Bangabandhu Sheikh Mujib Medical University,Shahbag,Dhaka

DOI:

https://doi.org/10.3329/jom.v25i2.74387

Keywords:

Papillary thyroid carcinoma, Thyroidectomy, Calcium,, Altered Consciousness, generalized weakness, Metabolic alkalosis.

Abstract

This case reports outlines a 76-year-old male’s progression from papillary thyroid carcinoma diagnosis to the development of Calcium-Alkali Syndrome (CAS) following thyroidectomy. Initially presenting with thyroid mass, surgery was followed by generalized weakness and altered sensorium, investigations that revealed elevated calcium levels ,metabolic alkalosis and renal impairment . Diagnosis pointed to CAS, likely triggered by prescribed calcium and calcitriol post-surgery. Cessation of supplements and hydration resulted in resolution. While post-thyroidectomy hypocalcemia is anticipated, CAS poses challenges, especially with increasing calcium supplement use. This emphasizes the need for vigilant monitoring of electrolyte imbalances, particularly in regions with limited follow-up practices. Clinicians should balance preventing hypocalcemia without risking hypercalcemia, stressing the importance of timely identification and tailored interventions to prevent CAS complications. This case underscores the significance of recognizing CAS as a potential postoperative complication, urging vigilant monitoring and tailored management in similar clinical settings.

J MEDICINE 2024; 25: 184-186

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Published

2024-07-16

How to Cite

Hossain , M. S., Azad, M. A. K., Rahaman, M. F. U. ., Aftab, K. A. ., Rahman, I. B. ., & Monira, S. . (2024). A Case of Milk Alkali Syndrome: The Forgotten Diagnosis of Generalized Weakness and Altered Consciousness. Journal of Medicine, 25(2), 184–186. https://doi.org/10.3329/jom.v25i2.74387

Issue

Vol. 25 No. 2 (2024)

Section

Case Reports

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