Milk-Alkali Syndrome in a Child with Primary Hypoparathyroidism during Maintenance Therapy

Calcium plays a critical role in neuromuscular excitement and other cellular functions. Therefore, extracellular calcium concentration is maintained within a very narrow range through interaction of calcium regulating hormones such as parathyroid hormone, calcitonin, and vitamin D in the presence of normal renal function. Special attention should be paid to patients on vitamin D and calcium supplementation in situations of dehydration and /or renal insufficiency, even though the usual dose of these supplements are unchanged over time. We report a case presenting with a triad of hypercalcemia, metabolic alkalosis and renal failure secondary to treatment of primary hypoparathyroidism.