The calcareous lung

A case report of pulmonary alveolar microlithiasis with pulmonary tuberculosis

Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease characterised by the deposition of calcium phosphate microliths in the alveoli. PAM has been reported in all continents and there is often a familial history. There is clinical-radiological dissociation as there is often a paucity of symptoms in contrast to the imaging findings. Patients often remain asymptomatic until the third or fourth decade of life, and dyspnea is the most common symptom. PAM is caused by a mutation within the solute carrier family 34 member 2 gene (the SLC34A2 gene) located on chromosome 4p15.2, which encodes a sodium/phosphate co-transporter. The imaging appearance of the disease is quite pathognomic with the high-resolution computed tomography (HRCT) demonstrating a diffuse micronodular appearance. Transbronchial lung biopsy also confirms the diagnosis. There is no effective therapy at present except lung transplantation. We herein, present a case of PAM along with clinical history, imaging study, histopathological study and genetic study of a 43-year-old female adult patient along with genetic analysis.

Pulmonary alveolar microlithiasis

Pulmonary alveolar microlithiasis (PAM) is a fascinating rare lung disease that is associated with the accumulation of hydroxyapatite microliths within the lumen of the alveolar spaces. In most patients, PAM is discovered incidentally on radiographs performed for other purposes, and the typical disease course is characterised by slowly progressive respiratory insufficiency over decades. Recent genetic analyses that have revealed that the deficiency of the sodium-phosphate cotransporter NPT2B is the cause of PAM have enabled the development of powerful animal models that inform our approach to disease management and treatment. Here we review the epidemiology and molecular pathophysiology of PAM, as well as the diagnostic approach, clinical manifestations, radiographic and pathologic features, and clinical management of the disease. Although there are no proven treatments for PAM, progress in our understanding of disease pathogenesis is providing insights that suggest strategies for trials.

A review of the epidemiology and molecular pathophysiology of pulmonary alveolar microlithiasishttps://bit.ly/3lBgM7p

Pulmonary Alveolar Microlithiasis: An Isolated Case in a Hispanic Male

Pulmonary alveolar microlithiasis (PAM) is an uncommon hereditary lung disease characterized by widespread deposition of calcium phosphate microliths within the alveolar spaces. It is considered an autosomal recessive disease with a mutation in a gene encoding a sodium phosphate cotransporter. The imaging findings in the early phase of disease can be mistaken for miliary tuberculosis or sarcoidosis. However, the classic radiologic findings in the later phases of disease show numerous opacities causing a “snowstorm” appearance to the lungs that corresponds with widespread deposition of microliths throughout the lung parenchyma. Although the disease often progresses over a slow time course, there are no effective therapies, and bilateral lung transplantation is recommended when there are increasing oxygen requirements or evidence of pulmonary hypertension.

Pulmonary alveolar microlithiasis with finger clubbing: A case report and literature review

Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive and slowly progressive disease. Mutations of the solute carrier family 34, member 2 gene are considered to be the cause of the disease. The present study reported the case of a 35-year-old female patient who was diagnosed with PAM. The parents of the patient were reported to be blood-related (cousins). The clinical manifestations and radiological and pathological characteristics of the patient are reported. A pulmonary function examination detected restrictive ventilatory and diffusion defects, and a high-resolution computed tomography scan showed multiple bilateral diffuse ground-glass opacifications and subpleural linear calcifications. A bronchoalveolar lavage fluid (BALF) examination detected a calcified body in the lavage fluid and a transbronchial biopsy showed numerous calcified bodies, concentrically laminated with an onion skin-like appearance in the alveolar spaces. Based on the aforementioned observations, the patient was diagnosed with PAM. Following administration of inhaled corticosteroid treatment, the symptoms were improved and the patient was discharged. After 1 year, the patient was lost to follow-up. The present study presents and reviews the typical radiological appearance, clinical presentation, pathological characteristics and treatments of PAM, and suggests that, often, the parents of the patients are blood-related and typically cousins. In addition, the present study proposes that a BALF examination may be considered an alternative method for the pathological diagnosis of PAM.

Pulmonary alveolar microlithiasis: review of the 1022 cases reported worldwide

Pulmonary alveolar microlithiasis (PAM) is a rare disease characterised by the widespread intra-alveolar accumulation of minute calculi called microliths. It is caused by mutation of the SLC34A2 gene encoding the type IIb sodium phosphate cotransporter in alveolar type II cells. The present study explores the epidemiological, familial, genetic, clinical, diagnostic, radiological and therapeutic aspects with the aim of contributing to a better understanding of this uncommon disease.We searched articles on PAM published up to December 2014 and 544 papers were found, accounting for 1022 cases.PAM is present in all continents and in many nations, in particular in Turkey, China, Japan, India, Italy and the USA. Familiality is frequent. The clinical course is not uniform and the causes of this clinical variability seem to be largely nongenetic. The optimal diagnostic procedure is the association of chest high-resolution computed tomography (HRCT) with bronchoalveolar lavage, but a chest radiograph may suffice in families in which a case has already been diagnosed. Moreover, chest radiography and HRCT allow the classification of the evolutionary phase of the disease and its severity. At present lung transplantation is the only effective therapy. However, better knowledge of the gene responsible offers hope for new therapies.