Prerequisites:
(1) significant calcium intake, usually 5-15 grams per day (Thakker).
(2) source of absorbable alkali
Sources of calcium:
(1) calcium carbonate (source of calcium as well as absorbable alkali)
(2) dairy products (milk, cheese, yoghurt)
(3) calcium supplements
Calcium carbonate may be found in:
(1) Tums and other calcium carbonate antacids
(2) Tylenol Plus and other oral analgesics combined with an antacid
(3) many other over-the-counter (OTC) preparations
Clinical features:
(1) hypercalcemia
(2) metabolic alkalosis (typically with elevated serum bicarbonate)
(3) nephrocalcinosis
(4) renal insufficiency, which can progress to renal failure
(5) often low serum parathyroid hormone (PTH) levels during hypercalcemia
(6) serum alkaline phosphatase is normal
If a large amount of milk is ingested then the serum phosphorus may be elevated (Beall and Scofield, page 93).
Treatment largely involves significantly reducing calcium and alkali intake and rehydration.
