A syndrome characterized by hypercalcemia without hypercalcuria or hypophosphatemia, with mild alkalosis, and transient renal insufficiency with azotemia. Serum phosphatase is normal. It is caused by excessive intake of milk or calcium with easy reabsorbing alkalis over a long period of time. It can also be caused by secondary or tertiary hyperparathyroidism, due to a chronic reduction of ionized calcium. The symptoms include nausea, vomiting, headache, irritability, vertigo, depression, confusion, weakness, and ataxia. Radiological findings show multiple calcium deposits in soft tissues. Three distinct forms of this condition are recognized: (1) temporary alkalosis and uremia during short intensive treatment with antacids; (2) a form similar to the first type but accompanied by hypercalcemia (Cope syndrome), and (3) and a chronic form characterized by permanent impairment of renal function (Burnett syndrome).
It was first described by L. L. Hardt and A. B. Rivers in 1923. Burnett and associates in 1949 reported detailed clinical and chemical studies of six cases, established the syndrome, and proved its reversibility. Wenger and associates subsequently reported 35 addition cases in 1958.
- L. L. Hardt, A. B. Rivers:
Toxic manifestations following the alkaline treatment of peptic ulcer.
Archives of Internal Medicine, Chicago, 1923, 31: 171-180.
- C. L. Cope:
Base changes in the alkalosis produced by the treatment of gastric ulcer with alkalies. Clinical Science, London, 1936, 2: 287-300.
- C. H. Burnett, R. R. Commons, Fuller Albright, J. E. Howard:
Hypercalcemia without hypercalcuria or hyposphatemia, calcinosis and renal insufficiency. A syndrome following prolonged intake of milk and alkali.
New England Journal of Medicine, Boston, 1949, 240: 787-794.
- J. Wenger, J. B. Kirsner, W. L. Palmer:
The milk-alkali syndrome; hypercalcemia, alkalosis and temporary renal insufficiency during milk-antacid therapy for peptic ulcer.
The American Journal of Medicine, New York, 1958, 24: 161-163.
- G. A. Cinotti:
[The milk-alkali syndrome (Cope-Burnett syndrome).] Rassegna di fisiopatologia clinica e terapeutica, Roma, November-December 1962, 34: 677-694.
- Dorlands Medical Dictionary on the Internet.