03 September 2022
: Case report 
Milk-Alkali Syndrome: How Electronic Medical Record Open Notes Helped to Rule Out Cancer
Challenging differential diagnosis, Management of emergency care, Rare disease, Adverse events of drug therapy
Michelle-Ashley Rizk1AEF, Nicholas Abourizk1AEF, Iuliia Kovalenko1EF*, Konstantin Golubykh
1EF, Bosky Soni1EF, Matthew Zaccheo2DE, Steve Zanders 2A
DOI: 10.12659/AJCR.936969
Am J Case Rep 2022; 23:e936969
Table 1. Laboratory values at admission and after treatment.
| Laboratory tests | Values on admission | Values after treatment | Reference range |
|---|---|---|---|
| Calcium | 17.4 | 6.6 | 8.6–10.3 mg/dL |
| Calcium, ionized | 2.01 | 0.93 | 1.10–1.35 mmol/L |
| Magnesium | 1.4 | 1.9 | 1.9–2.7 mg/dL |
| Parathyroid hormone | 15 | 12–88 pg/mL | |
| Parathyroid hormone-related protein | 10 | 14–27 pg/mL | |
| Vitamin D 1,25-dihydroxy | <8 | 18–72 pg/mL | |
| Vitamin D 25 hydroxy | 9 | 30–100 pg/mL | |
| Thyroid stimulating hormone | 1.46 | 0.35–5.5 µIU/mL | |
| Serum protein electrophoresis | No M spike detected | ||
| White blood cells | 28.2 | 13.2 | 3.9–9.5 K/µL |
| Hemoglobin | 13.5 | 11.2 | 12.8–16.6 g/dL |
| Platelets | 352 | 360 | 140–366 K/µL |
| Sodium | 146 | 142 | 136–145 mEq/L |
| Potassium | 3.6 | 4.4 | 3.5–5.1 mEq/L |
| Chloride | 83 | 107 | 98–107 mEq/L |
| Carbon dioxide | >45 | 27 | 19.0–33.0 mEq/L |
| Glucose | 82 | 90 | 70–99 mg/dL |
| Blood urea nitrogen | 90 | 8 | 7–25 mg/dL |
| Creatinine | 7.18 | 1.31 | 0.70–1.30 mg/dL |
| Anion gap | 9 | 8 | 7–12 mEq/L |
| pH (arterial) | 7.44 | 7.35–7.45 pH | |
| Phosphorus | 2.2 | 2.4 | 2.3–4.6 mg/dL |
| Angiotensin-converting enzyme | 6 | 9–67 U/L | |
| Troponin I | 0.26 | <0.03 | <0.03 ng/mL |
| Free Kappa light chains | 54.3 | 3.3–19.4 mg/L | |
| Prostate-specific antigen | 29.12 | ≤4.0 ng/mL | |
| Ammonia | 27 | 6–47 UMOL/L |