The milk-alkali syndrome caused by betelnuts in oyster shell paste

Background: The carcinogenic effect of betelnut chewing leading to oral cancer is well known. Betelnut chewing may also affect the autonomic nervous system. In this report, we present another potential hazard of betelnuts, milk-alkali syndrome. Case Report: Two patients who had chewed a large quanti...

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Bibliographic Details
Published inJournal of toxicology. Clinical toxicology Vol. 34; no. 6; p. 741
Main Authors Wu, K.D. (National Taiwan University Hospital, Taipei, Taiwan.), Chuang, R.B, Wu, F.L, Hsu, W.A, Jan, I.S, Tsai, K.S
Format Journal Article
LanguageEnglish
Published United States 1996
Subjects
ALCALOSE
ALCALOSIS
Areca - chemistry
BETEL
Calcium Carbonate - administration & dosage
Calcium Carbonate - poisoning
CARBONATE DE CALCIUM
CARBONATO DE CALCIO
CONCHA
COQUILLE
DIAGNOSTIC
DIAGNOSTICO
Dosage Forms
ESTUDIOS DE CASOS PRACTICOS
ETUDE DE CAS
FONCTION PHYSIOLOGIQUE
FUNCION FISIOLOGICA
HIPERCALCEMIA
HUITRE
Humans
Hypercalcemia - etiology
Hypercalcemia - pathology
HYPERCALCEMIE
Male
Middle Aged
OSTRA
Plants, Medicinal
Poisoning - complications
REIN
RINONES
TOXICIDAD
TOXICITE
TRASTORNOS METABOLICOS
TROUBLE DU METABOLISME
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Summary:Background: The carcinogenic effect of betelnut chewing leading to oral cancer is well known. Betelnut chewing may also affect the autonomic nervous system. In this report, we present another potential hazard of betelnuts, milk-alkali syndrome. Case Report: Two patients who had chewed a large quantity of betelnuts developed hypercalcemia, metabolic alkalosis, and renal insufficiency. They ingested a large amount of calcium carbonate from a local special paste used for betelnut preparation, the main ingredient of which is ground oyster shell. The symptoms and metabolic abnormalities disappeared promptly after abstinence from betelnut chewing and administration of saline solution. Improvement of renal function was observed in both patients. Analysis of the calcium content of the paste suggested that the patients might have ingested 9 g and 6 g of calcium carbonate per day, respectively. Conclusion: This is the first report of milk-alkali syndrome not caused iatrogenically, but by recreational usage of oyster shell preparations of betelnuts
Bibliography:9706249
L74
S30
ISSN:0731-3810
1097-9875
DOI:10.3109/15563659609013839