Milk-Alkali syndrome in pregnancy

BACKGROUND:: Severe hypercalcemia, a potentially life-threatening medical emergency, is rare in pregnancy. CASE:: We report a 32-year-old woman presenting early in the second trimester with severe hypercalcemia (total calcium 22mg/dL), alkalosis, and acute renal insufficiency resulting from excessive ingestion of calcium carbonate-containing antacid for gastroesophageal reflux. The patient was treated with aggressive hydration and furosemide, and received 1 dose of intravenous etidronate, leading to short-term symptomatic hypocalcemia. To our knowledge, this is the third reported case of milk-alkali syndrome in pregnancy. CONCLUSION:: Milk-alkali syndrome is an uncommon cause of hypercalcemia in pregnancy. Intravenous hydration with saline should be the cornerstone of treatment, reserving bisphosphonates for selected cases.