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Diagnosis:

Prior to an official diagnosis of milk-alkali syndrome, other causes of hypercalcemia must be ruled out. Other causes of hypercalcemia can include elevated vitamin D levels, hyperthyroidism, and hyperparathyroidism.

Physical Examination:

Symptoms such as vertigo, confusion, apathy, nausea and vomiting, anorexia, tremors, psychosis, myalgia, polyuria, abnormal calcifications such as renal calcifications, and pruitus could be observed in people.

Lab work:

Lab work must be done to diagnose milk-alkali syndrome. Lab workup includes serum calcium levels, parathyroid hormone (PTH), phosphorus, creatinine, blood urea nitrogen (BUN), magnesium, and vitamin D levels. primary hyperparathyroidism has to be excluded. Diagnosis is made by looking at past medical history and laboratory studies.


 * 1) Serum calcium levels: high serum calcium levels.
 * 2) PTH: low serum PTH levels are indicative of MAS. Low serum PTH levels also exclude primary hyperthyroidism.
 * 3) Phosphorus: low serum phosphorus levels due to low PTH.
 * 4) Creatinine and BUN: high levels can indicate severity of renal damage.
 * 5) Magnesium: serum magnesium levels are low as hypercalcemia inhibits mg^2+ reabsorption in the renal tubules.
 * 6) Vitamin D levels: low vitamin D levels are found. Normal vitamin D levels eliminate primary hypercalcemia.ECG intervals

Electrocardiograms (ECG):

An ECG can also be used to diagnose MAS. The following findings related to hypercalcemia could appear on an ECG:


 * 1) Short QT interval: most commonly seen as short OoT or OaT changes.
 * 2) Prolongation of PR and QRS intervals.
 * 3) Increased Amplitude of QRS complex.
 * 4) Osborn wave
 * 5) Short ST segment.

Radiology:

Chest x-rays can help exclude any malignancy or sarcoidosis when evaluating for hypercalcemia.

Milk Alkali Syndrome and the Dynamics of Calcium Homeostasis