Pneumology - Case Reports Open access

Pulmonary alveolar microlithiasis: Blizzard of lung

Authors

Published
10 June 2021
Section
Pneumology - Case Reports

Abstract

Pulmonary alveolar microlithiasis (PAM) is a rare inherited disorder in which patients present with either nonspecific signs and symptoms or are asymptomatic. Clinical-radiological dissociation is a commonly seen feature of the disease. Majority of cases are diagnosed in second and third decade of life, although presentation in paediatric and elderly population is also reported. Pathognomonic radiological findings, with normal calcium and phosphate levels can confirm the diagnosis without the need of further investigations in large number of cases. A high index of suspicion and knowledge of the disease is of paramount importance as it has a wide range of presentation and variable course thus posing a diagnostic challenge. We present two cases of this rare disease in elderly females with distinct presentations although with similar and characteristic radiological findings along with a brief review of literature of the disease.

References

  1. Castellana G, Castellana G, Gentile M, et al. Pulmonary alveolar microlithiasis: Review of the 1022 cases reported worldwide. Eur Respir Rev 2015;24:607-20. DOI: https://doi.org/10.1183/16000617.0036-2015
  2. Tendolkar M. An “Orphan” in search of a treatment: Pulmonary alveolar microlithiasis. Lung India 2019;36:553. DOI: https://doi.org/10.4103/lungindia.lungindia_437_19
  3. Viswananthan R. Pulmonary alveolar microlithiasis. Thorax 1962;17:251-6. DOI: https://doi.org/10.1136/thx.17.3.251
  4. Harbitz F. Extensive calcification of the lungs as a distinct disease. Arch Intern Med (Chic) 1918;XXI:139-46. DOI: https://doi.org/10.1001/archinte.1918.00090070150012
  5. Saito A, McCormack FX. Pulmonary Alveolar Microlithiasis. Clin Chest Med. 2016;37:441-8. DOI: https://doi.org/10.1016/j.ccm.2016.04.007
  6. Castellana G, Gentile M, Castellana R, et al. Pulmonary alveolar microlithiasis: clinical features, evolution of the phenotype, and review of the literature. Am J Med Genet 2002;111:220–4. DOI: https://doi.org/10.1002/ajmg.10530
  7. Tachibana T, Hagiwara K, Johkoh T. Pulmonary alveolar microlithiasis: Review and management. Curr Opin Pulm Med 2009;15:486-90. DOI: https://doi.org/10.1097/MCP.0b013e32832d03bb
  8. Castellana G, Carone D, Castellana M. Microlithiasis of seminal vesicles and severe oligoasthenospermia in pulmonary alveolar microlithiasis (PAM): report of an unusual sporadic case. Int J Fertil Steril 2015; 9:137-40.
  9. Balikian JP, Fuleihan FJ, Nucho CN. Pulmonary alveolar microlithiasis. Report of five cases with special reference to roentgen manifestations. Am J Roentgenol Radium Ther Nucl Med 1968;103:509-18. DOI: https://doi.org/10.2214/ajr.103.3.509
  10. Felson B. Thoracic calcifications. Dis Chest 1969;56:330-43. DOI: https://doi.org/10.1378/chest.56.4.330
  11. Cluzel P, Grenier P, Bernadac P, et al. Pulmonary alveolar microlithiasis: Ct findings. J Comput Assist Tomog. 1991;15:938-42. DOI: https://doi.org/10.1097/00004728-199111000-00006
  12. Pracyk JB, Simonson SG, Young SL, et al. Composition of lung lavage in pulmonary alveolar microlithiasis. Respiration 1996;63:254-60. DOI: https://doi.org/10.1159/000196556
  13. Ganesan N, Ambroise MM, Ramdas A, et al. Pulmonary alveolar microlithiasis: an interesting case report with systematic review of Indian literature. Front Med 2015;9:229-38. DOI: https://doi.org/10.1007/s11684-015-0394-y
  14. Belém LC, Zanetti G, Souza AS, et al. Metastatic pulmonary calcification: State-of-the-art review focused on imaging findings. Respir Med 2014;108:668-76. DOI: https://doi.org/10.1016/j.rmed.2014.01.012
  15. Ozcelik U, Yalcin E, Arıyurek M, et al. Long-term results of disodium etidronate treatment in pulmonary alveolar microlithiasis. Pediatr Pulmonol 2010;45:514-7. DOI: https://doi.org/10.1002/ppul.21209
  16. Stamatis G, Zerkowski H, Doetsch N, et al. Sequential bilateral lung transplantation for pulmonary alveolar microlithiasis. Ann Thorac Surg 1993;56:972-5. DOI: https://doi.org/10.1016/0003-4975(93)90370-W
  17. Jindal A, Rahulan V, Balasubramani G, et al. Pulmonary alveolar microlithiasis: A rare disease treated with lung transplantation, first case from India. Lung India 2019;36:546. DOI: https://doi.org/10.4103/lungindia.lungindia_50_19

Metrics

Citations and online attention from Dimensions, Altmetric and PlumX.