Irreversible lung damage due to lung disorder
Pulmonary alveolar microlithiasis is a disorder in which microliths accumulate in the alveoli across the lungs. The microlits are composed of a compound called calcium phosphate. This article describes the case of a 36-year-old woman diagnosed with the condition. She presented with complaints of 2-month history of fever, worsening shortness of breath, cough and night sweats.
Examination of the patient showed that her oxygen saturation levels were 88% in ambient air. Doctors further advised a chest radiograph which were significant for miconodular opacities with a “sandstorm” appearance. A CT scan of the chest was also performed which showed the presence of calcified micronodules, cavitation and ground-glass opacities.
However, the patient’s sputum smear was negative for acid-fast bacilli. For further evaluation, a transbronchial biopsy was performed of the tissue which showed microliths. Similarly, bronchial aspirate was positive for Mycobacterium tuberculosis. The patient was negative for human immunodeficiency virus antibodies.
Doctors diagnosed the patient with pulmonary alveolar microlithiasis which was complicated by the presence of tuberculosis.
Treatment included a medication regime for tuberculosis. The patient’s fever, night sweats and cough resolved 4 weeks after treatment. Although her shortness of breath was still a concern. The only other option of treatment available is lung transplantation which was not an option for the patient because a constraint of resources.
The calcium deposits cause widespread damage to the lung tissue and alveoli which leads to breathing problems. It is generally diagnosed before the age of 40, however, the condition typically worsens over the years, causing irreversible damage to the lungs, as in this case.
Pulmonary Alveolar Microlithiasis Complicated by Tuberculosis https://www.nejm.org/doi/full/10.1056/NEJMicm2028047