Diseases

Burnett Syndrome – Causes, Symptoms & Treatment

Burnett Syndrome

Patients with Burnett syndrome suffer from calcium and alkali excess, often due to dietary supplements. It is also known as milk-alkali syndrome . In addition to calcium deposits in the conjunctiva and cornea, symptomatic ataxia, nausea and vomiting can occur.

What is Burnett Syndrome?

Burnett’s syndrome is also known as milk-alkali syndrome. This is a disorder of calcium metabolism associated with an oversupply of calcium and easily absorbed alkalis. The syndrome occurs in most cases as a result of the treatment of other diseases. The metabolic disorder is named after the American doctor Charles Hoyt Burnett.

At the beginning of the 20th century, doctors sometimes treated stomach ulcers by administering milk, alkaline powder and cream every hour. This milk-alkaline treatment improved the symptoms of the stomach ulcer. However, the therapy was often associated with serious side effects that went as far as kidney failure . In connection with this peptic ulcer treatment, Burnett’s or milk-alkaline syndrome was the most common. Once better treatment options for gastric ulcers became available, the incidence of the syndrome declined. However, Burnett syndrome is now becoming more common again.

causes

During digestion, the gastrointestinal tract absorbs alkalis via bicarbonate and calcium via foods such as milk. It makes these substances available to the organism via absorption in the stomach and intestines. In Burnett syndrome, the calcium level in the serum is particularly high. This increase is due to increased absorption of calcium or in the gastrointestinal tract and is therefore usually related to the excessive consumption of calcium-containing or alkaline foods.

This excessive consumption occurred in the 20th century, particularly in the context of gastric ulcer therapy. In the 21st century, the scenario often affects women with osteoporosis who consume more than the recommended 1200 to 1500 milligrams of calcium to prevent or control the disease. The syndrome is also favored by the intake of vitamin D.

Symptoms, Ailments & Signs

The most common symptoms of Burnett syndrome are nausea , vomiting , and dizziness . Sometimes there is also ataxia , i.e. a gait disorder. In addition to increased serum calcium, i.e. hypercalcemia , calcinosis can also occur. In the case of calcinosis, the excess calcium is stored by the body in the conjunctiva, the cornea or the renal tubules. Storage in the kidneys can lead to renal insufficiency .

The one in the eyes is often visible at first glance and often affects the eyelid fissure in particular, where it can trigger bankeratitis. Sometimes, with pronounced calcinosis, there are also neurological symptoms such as depression , confusion and persistent fatigue . The more severe the case, the more severe these disturbances of consciousness can be. In extreme cases, the neurological symptoms can extend to comatose appearances.

Diagnosis & History

The anamnesis gives the doctor the first indications of Burnett’s syndrome. As a rule, the history of the intake of dietary supplements such as calcium or alkaline salts turns out to be evident. An elevated calcium level in the blood speaks for Burnett’s syndrome. Hardly any calcium can be detected in the urine because hypercalcemia narrows the blood vessels of the kidneys, preventing them from excreting it.

Elevated parathyroid hormone levels and metabolic alkalosis with elevated phosphate levels also suggest the syndrome. In the modern form, however, the phosphate level often remains unchanged. The course depends on where and how much calcium was stored. Deaths from kidney failure have also been reported in some cases in the past in connection with the syndrome. Today, however, fatal consequences are virtually impossible.

When should you go to the doctor?

As a rule, Burnett syndrome does not heal itself if the person affected does not change their diet. Because of this, medical evaluation and treatment is necessary to prevent further complications from the syndrome. A doctor should be consulted if the person suffers from vomiting or nausea for a long period of time and without a specific reason.

Dizziness and gait disturbances also occur relatively frequently and can indicate the disease. Renal failure can also occur if left untreated. Should kidney problems occur, a doctor must be consulted immediately. Confusion or depression are also among the symptoms of Burnett syndrome and should be investigated if they persist over a longer period of time. In some cases, the sufferer may also lose consciousness or go into a coma with this condition.

The first examination is usually carried out by a general practitioner. In emergencies, however, you can go to the hospital or call an ambulance .

Treatment & Therapy

The first step in treating patients with Burnett syndrome is to stop calcium intake immediately. In most cases, the doctor combines this measure with the administration of saline solutions. This isotonic solution is usually administered intravenously. The aim of this therapeutic measure is to hydrate and support the kidneys.

The saline solution is intended to inhibit passive-tubular reabsorption in the tubular system of the kidneys. The tubules of the kidneys reabsorb many substances that have been filtered out in the course of reabsorption. In particular, an elevated blood phosphate level can be compensated for by administering saline solution. Namely, the liquid saturates the reabsorption. The superfluous phosphate and calcium are excreted in this way until the level in the blood has normalized. During inpatient treatment, serum calcium is continuously monitored.

If only a mild form of Burnett syndrome is present, treatment usually takes place on an outpatient basis and close monitoring is not required. Some patients with Burnett syndrome are also given a diuretic loop diuretic to stimulate the kidneys. However, taking too much of this drug can make it worse and worsen calcinosis. Therefore, this form of treatment mostly refers to inpatients who can be monitored for safety.

Outlook & Forecast

In most cases, Burnett’s syndrome can be treated relatively easily and effectively. If the person concerned does not seek treatment despite the appearance of the symptoms, Burnett syndrome can lead to serious consequences and, in the worst case, to the death of the person concerned. However, this only occurs with a very long-lasting consumption of supplements.

The syndrome itself is treated by having the patient stop taking the supplements. There are no further complaints and the symptoms subside over time. In acute emergencies, the state of health can be improved by taking calcium . The affected person also receives various injections to relieve the kidneys.

Irreversible damage from Burnett syndrome usually only occurs if no treatment is given and if calcium is taken in large quantities over a very long period of time. The syndrome cannot occur with an ordinary diet. The further course or the severity of the symptoms also depend heavily on the amount of calcium actually taken. In general, however, the disease can be treated very well.

prevention

To prevent Burnett syndrome, the daily calcium intake should not exceed a dose between 1200 and 1500 milligrams. Alkaline and calcium-containing food supplements should always be handled with care. Burnett’s syndrome is not likely to develop from actual diet.

aftercare

In the first time after an occurrence, a check can be useful. However, this only applies to serious illnesses. Since kidney failure is imminent in the worst case, adequate laboratory tests of the blood should be carried out. A determination of serum calcium and serum phosphate is particularly useful. A special case is the occurrence as a result of other treatments such as gastric ulcers .

If the previous treatment is continued, those affected cannot avoid aftercare. As long as diseases favor the occurrence, even close-meshed long-term treatment is advisable. Regular appointments should be made with a general practitioner in order not to risk kidney failure. However, the disease is usually mild. Then medical follow-up care is not necessarily advisable.

Statistically, complications are not to be expected. Rather, the obligation to take preventive action then applies. Daily calcium intake should not exceed 1,500 milligrams. Foods containing calcium should be avoided in everyday nutrition.

With a normal lifestyle, there is no danger. It is unlikely that the disease will recur after mild and moderate symptoms have subsided, which is why continuous follow-up care can be dispensed with. If the known symptoms occur again, patients should definitely consult a doctor.

You can do that yourself

In severe cases, Burnett syndrome can lead to kidney failure, which is why patients should always consult a doctor as soon as possible.

The disease particularly often affects women who take high-dose calcium supplements for the purpose of prophylaxis or treatment of osteoporosis. If this group of people shows symptoms of Burnett syndrome, including nausea, dizziness, vomiting and occasionally walking difficulties (ataxia) in the early stages, medical help must be sought promptly.

It is imperative that the attending physician be informed about the intake of calcium. The most important treatment step is usually to stop taking these drugs. In addition, calcium intake generally has to be lowered for a certain period of time.

In many cases, those affected are forced to change their diet , at least temporarily. Calcium-rich foods such as cow’s milk, cheese, yoghurt , quark or whey-based diet shakes must then be avoided. If you do not want to do without these foods completely, you can switch to plant-based substitutes. Especially cow’s milk can be replaced very well with soy or almond drinks.

Plant-based alternatives are also already available for cheese and yoghurt. While calcium is rarely found naturally in these products, it is sometimes added. Those affected should therefore pay attention to information such as “with calcium” and study the ingredients. If you are unsure, you can get competent advice in organic supermarkets and health food stores.

Lisa Newlon
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Hello! I am Lisa Newlon, and I am a medical writer and researcher with over 10 years of experience in the healthcare industry. I have a Master’s degree in Medicine, and my deep understanding of medical terminology, practices, and procedures has made me a trusted source of information in the medical world.