Sarath Kumar H¹*, Elizabeth Jacob², Sumesh Raj², Manoj P³ and Tony P Joseph⁴

¹Post Graduate Resident, Department of General Medicine, Sree Gokulam Medical College and Research Foundation, India
²Professor, Department of General Medicine, Sree Gokulam Medical College and Research Foundation, India
³Consultant Neurologist, Department of Neuromedicine, Sree Gokulam Medical College and Research Foundation, India
⁴Consultant Endocrinologist, Department of Endocrinology, Sree Gokulam Medical College and Research Foundation, India

*Corresponding Author: Sarath Kumar H, Post Graduate Resident, Department of General Medicine, Sree Gokulam Medical College and Research Foundation, India.

Received: February 07, 2024; Published: March 06, 2024

Abstract

This is a case of 75-year-old lady known case of chronic kidney disease, coronary artery disease, recent stroke – left hemiparesis, diabetes mellitus, systemic hypertension, recurrent seizures probably due to hypocalcemia, post thyroidectomy on supplements. She presented with acute onset of recurrent left sided weakness, mental confusion, and decreased urine output for 3 days. On examination she was drowsy, left hemiparesis with stable vitals. Investigations revealed raised serum calcium and creatinine levels. ABG showed metabolic alkalosis. MRI Brain suggestive of PRES. She was initially treated as a case of recurrent stroke with PRES. Subsequent evaluation revealed persisting hypercalcemia and worsening of renal parameters. Further workup ruled out hyperparathyroidism and malignancy. Repeated enquiry revealed that patient had been taking calcium supplements equivalent to 4 gm of elemental calcium, calcitriol and vitamin D3 supplements and was on irregular follow up. A diagnosis of milk alkali syndrome presenting with recurrent worsening of pre-existing left hemiparesis was made. Calcium supplements withheld and was on adequate fluid therapy. She became symptomatically better.

Keywords: Hypercalcemia; ECG; Alkalosis; AKI; PRES

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Citation

Citation: Sarath Kumar H., et al. “A Case Report on Milk Alkali Syndrome Presenting as Recurrent Stroke with Posterior Reversible Encephalopathy".Acta Scientific Clinical Case Reports 5.4 (2024): 11-14.

Copyright

Copyright: © 2024 Sarath Kumar H., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.