Metastatic Pulmonary Calcification  

Oleh:

Timmins, Sophie ; Hibbert, Michael

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 363 no. 26 (Dec. 2010), page 2547.
Fulltext: Metastatic Pulmonary Calcification.pdf (293.65KB)

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2010.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

A chest radiograph of a 47-year-old woman with a dry cough and mild exertional dyspnea showed poorly defined bilateral nodular opacities in the superior lung fields (Panel A). The patient had undergone renal transplantation at 23 years of age for an unspecified glomerulonephritis. She had no history of exposure to tobacco or occupational aerosols. An axial computed tomographic scan of the chest showed centrilobular ground-glass nodules and heterogeneous attenuation, features that were suggestive of calcium deposition (Panel B). Results of serum tests revealed increased serum creatinine (285 µmol per liter [3.2 mg per deciliter]), a normal calcium level (2.3 mmol per liter [9.2 mg per deciliter], corrected for the serum albumin level), a normal phosphate level (1.4 mmol per liter [4.3 mg per deciliter]), increased parathyroid hormone (1571 ng per liter), and a low vitamin D level (calcidiol, 13.4 nmol per liter [5.4 ng per milliliter], and calcitriol, 20 pmol per liter [7.7 ng per milliliter]). Bronchoalveolar washings were negative for mycobacterial and fungal infection. On the basis of these findings, the patient received a diagnosis of metastatic pulmonary calcification due to chronic renal impairment and secondary hyperparathyroidism. Results of pulmonary-function tests, which showed mild restriction and moderate diffusion impairment, were consistent with the diagnosis. The patient's lung function and symptoms have remained stable for 18 months while she has been treated with phosphate binders, vitamin D supplementation, and cinacalcet, a calcimimetic agent.

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