Blizzard of Lung

A 30-year-old female patient complained of dyspnea after activity for more than 2 years. Plain chest computed tomography scan showed diffuse patchy, small nodular increased density in both lungs, mainly in the lower lobes of both lungs. Subpleural interstitial thickening and diffuse interlobular septa thickening were observed in both lungs (Figure 1). The right heart enlarged and the pulmonary trunk widened. The patient's activity tolerance from childhood was worse than that of her peers. The patient was asked about her medical history again. She had been treated in another hospital and pathological biopsy was performed, which indicated “a large amount of calcium salt deposition in the alveolar cavity”. After symptomatic treatment, the patient's condition improved and she was discharged. Pulmonary alveolar microlithiasis is a rare autosomal recessive disease characterized by intraalveolar accumulation of excessive calcium phosphate microliths.1Erel F. Güngör C. Sarıoğlu N. et al.Spontaneous pneumomediastinum and subcutaneous emphysema secondary to pulmonary alveolar microlithiasis.Tuberk Toraks. 2021; 69: 416-420Crossref Scopus (1) Google Scholar A common feature of the disease is considered as clinical-radiologic dissociation.2Mittal R. Kumar R. Srikanth J.K. et al.Pulmonary alveolar microlithiasis: blizzard of lung.Monaldi Arch Chest Dis. 2021; 91: 1709Google Scholar Lung transplantation is the treatment for this disease when it causes respiratory failure.3Ahmed M.H. Ismail M.S. Saleh W.N. et al.A single center case series of lung transplantation for a rare indication, pulmonary alveolar microlithiasis.J Heart Lung Transplant. 2020; 39: 368Abstract Full Text Full Text PDF Scopus (0) Google Scholar