갑상선 수술 후 부갑상선 기능 저하 환자에서 발생한 우유-알칼리 증후군 1예 = A Case of Milk-Alkali Syndrome in a Patient with Hypoparathyroidism after Total Thyroidectomy

다국어 초록 (Multilingual Abstract)

Milk-alkali syndrome (MAS) is a disorder featuring hypercalcemia, renal failure and metabolic alkalosis due to ingestion of large amounts of calcium and absorbable alkali. MAS was first reported after Milk-alkali treatment of peptic ulcer in early 1910. But since the late 20th century, the wide availability and increasing consumption of calcium carbonate and vitamin D supplementation mostly for osteoporosis prevention has been noted as reemerging clinical backgrounds of MAS. We experienced a case of a woman who had taken calcium and vitamin D for a year due to hypoparathyroidism after total thyroidectomy. She was admitted suffering from nausea, vomiting, anorexia and irritability with the triad of hypercalcemia, metabolic alkalosis and acute renal insufficiency. Every abnormal symptom, calcium level and renal function were normalized with fluid and diuretic therapies.

참고문헌 (Reference)

1 김바울, "탄산칼슘 과용량 복용에 의한 우유 알칼리 증후군 1예" 대한신장학회 23 (23): 633-637, 2004

2 전은실, "이뇨제 사용의 원칙과 실제" 대한내과학회 80 (80): 8-14, 2011

3 박용완, "원발성 부갑상선 기능저하증 치료중에 발생한 우유 알칼리 증후군 1예" 대한내분비학회 19 (19): 439-445, 2004

4 이양덕, "우유알칼리증후군 1예" 대한신장학회 20 (20): 315-318, 2001

5 김철수, "수술 후 부갑상선기능저하증 환자에서 발생한 우유-알칼리 증후군" 대한갑상선-내분비외과학회 14 (14): 85-88, 2014

6 정주환, "갑상선 절제술 후 부갑상선 기능저하증의 양상 및 부갑상선 자가이식의 효과" 대한이비인후과학회 56 (56): 28-33, 2013

7 Orwoll ES, "The milk-alkali syndrome: current concepts" 97 (97): 242-248, 1982

8 Park JM, "The incidence and causes of hypercalcemia in a hospital population" 8 (8): 72-77, 1993

9 Beall DP, "Milk-alkali syndrome: a historical review and description of the modern version of the syndrome" 331 (331): 233-242, 2006

10 Beall DP, "Milk-alkali syndrome associated with calcium carbonate consumption. Report of 7 patients with parathyroid hormone levels and an estimate of prevalence among patients hospitalized with hypercalcemia" 74 (74): 89-96, 1995

11 Jong Hyeok Jeong, "Hypercalcemia Associated with Acute Kidney Injury and Metabolic Alkalosis" 대한전해질학회 8 (8): 92-94, 2010

12 Lafferty FW, "Differential diagnosis of hypercalcemia" 6 (6): S51-S59, 1991

13 Lee KD, "Complications following thyroid surgery" 44 (44): 522-527, 2001

14 Patel AM, "Calcium-alkali syndrome in the modern era" 5 (5): 4880-4893, 2013

15 Kim JH, "Calcium Metabolism and Hyper and Hypoparathyroidism" 32 (32): 179-186, 2012