European Journal of Case Reports in Internal Medicine (Oct 2022)

Diagnostic Images of Pulmonary Alveolar Microlithiasis: A Rare, Autosomal Recessive Disorder

  • Fabia Cruz,
  • Diogo Batista,
  • Cátia Pereira,
  • Vera Durão,
  • Rita Macedo,
  • Richard Staats,
  • Paula Pinto,
  • Cristina Bárbara

DOI
https://doi.org/10.12890/2022_003575

Abstract

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Pulmonary alveolar microlithiasis (PAM) is a genetic lung disorder that is characterized by the accumulation of calcium phosphate deposits in the alveolar spaces of the lung. PAM is discovered incidentally on radiographs performed for other purposes, and the typical disease course is characterized by slowly progressive respiratory failure over decades. Treatment remains supportive. A 62-year-old woman presented in the emergency department with dyspnoea and fatigue. On physical examination she had crackles on pulmonary auscultation and digital clubbing. A CT scan of the chest showed multiple high-density areas throughout the lung parenchyma, suggesting the presence of alveolar microlithiasis. This CT finding is the typical radiological presentation of PAM, while the hallmark presentation is clinical–radiological dissociation.

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