Milk-Alkali Syndrome Associated with Use of Calcitriol and Calcium Carbonate in Aged-Patient with Osteoporosis- A Case Report

乳－鹼症候群是過量攝取鈣與可吸收的鹼所引起，臨床上以代謝性鹼中毒，高血鈣與腎功能不良為特徵，我們報告一位70歲女性因有多處骨折及骨質疏鬆症在服用碳酸鈣和活性維他命D治療一個月後，產生全身倦怠，食慾不振，嘔吐，呼吸微弱及意識改變，實驗結果顯示代謝性鹼中毒pH 7.51，PCO2 52 mmHg，PO2 66.4 mmHg，HCO3 40.6 meq/L，高血鈣15.9 mg/dl，和腎衰竭，肌酸肝3.3 mg/dl，尿素氮77 mg/dl，在停用碳酸鈣和活性維他命D及使用靜脈生理食鹽水注射治療，病人在七天後完全康復，故臨床上若發現代謝性鹼中毒合併高血鈣和腎功能不良時，應考慮此乳－鹼症候群以避免併發症發生。

關鍵字

乳－鹼症候群；活性維他命D ；碳酸鈣

並列摘要

Milk-alkali syndrome caused by excessive intake of calcium and absorbable alkali is characterized by the triad of metabolic alkalosis, hypercalcemia and renal failure. We reported a 70-year-old female suffering from lethargy, poor appetite, nausea, bradypnea, and altered level of consciousness one month after receiving calcium carbonate and calcitriol prescribed for her multiple bone fractures and osteoporosis. Laboratory data revealed metabolic alkalosis with pH 7.51, PCO2 52 mmHg, PO2 66.4 mmHg and HCO3- 40.6 mEq/L, impaired renal function with creatinine 3.3 mg/dl and BUN 77 mg/dl, and hypercalcemia 15.9 mg/dl. All of the above abnormalities resolved one week after discontinuation of the offending medications and administration of intravenous saline, The findings of renal failure and hypercalcemia in the presence of metabolic alkalosis should alert the physician this possible diagnosis.

並列關鍵字

milk-alkali syndrome ； calcitriol ； calcium carbonate

國際替代計量

Milk-Alkali Syndrome Associated with Use of Calcitriol and Calcium Carbonate in Aged-Patient with Osteoporosis- A Case Report

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