Milk-alkali syndrome: The forgotten diagnosis for altered sensorium

Milk-alkali syndrome (MAS) is one of the causes of hypercalcaemia. We report a case of a 75-year-old lady with a history of thyroidectomy, presented with an altered mental state and had an extremely high calcium concentration of 4.96mmol/L. The hypercalcemia was attributed to the ingestion of large doses of calcium supplements, including calcium carbonate and calcium lactate, leading to MAS. She was managed with intravenous fluids, diuretics and withdrawal of calcium supplements. The patient responded well to treatment and regained consciousness. Details of the case including clinical presentations, electrocardiogram (ECG) findings and treatment plan, are discussed in this article.