THE BURNETT OR MILK-ALKALI SYNDROME

Burnett and his co-workers¹ described in 1949 a syndrome that has many features in common with primary hyperparathyroidism with secondary kidney damage. This particular syndrome, however, has an entirely different etiology. The characteristic features they had observed in their series of six patients consisted of a history of prolonged and excessive intake of milk and of absorbable alkalies. The other features were hypercalcemia without hypercalciuria or hyperphosphatemia; normal serum alkali phosphatase level; marked renal insufficiency with azotemia; mild alkalosis; calcinosis manifested especially by an ocular lesion resembling band keratitis; and what was most important, improvement in the clinical state with an intake low in milk and absorbable alkali.

The most striking physical finding in their patients and the only one common to all six was found in the eyes. These lesions were believed to be associated with hypercalcemia. One of these is "band keratopathy." The other type of lesion