The Milk-Alkali Syndrome

I. The Diversity of Clinical Manifestations Eleven years ago Burnett and his associates¹described a syndrome occurring in patients who had ingested milk and absorbable alkali for prolonged periods of time. The characteristic features were hypercalcemia without hypercalciuria or hypophosphatemia, mild alkalosis, a normal serum alkaline phosphatase, severe renal insufficiency with azotemia, and calcinosis manifested chiefly by the presence of band keratopathy. Improvement followed restriction of the intake of milk and absorbable alkali. In the intervening decade it has become apparent that there are many variants in the "milk-alkali syndrome," as it has now come to be known.²⁻²⁰It is the purpose of this paper to present 4 cases illustrating the variability of manifestations which may result from excessive intake of milk and to stress 3 facts: 1. Hypercalcemia may continue for many months after cessation of a large calcium intake; 2. Moderate impairment in renal function with