Metastatic Pulmonary Calcification in Sarcoidosis

Rohatgi, Prashant K.

doi:10.1159/000195523

Cited by 4 publications

(2 citation statements)

References 8 publications

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“…Dystrophic calcification follows caseation, necrosis, or fibrosis and may complicate pulmonary infections that include ( 1 ) granulomatous infections, for example, Histoplasma capsulatum (22), Coccidioides immitis (23), and Mycobacterium tuberculosis (24); ( 2 ) viral infections, for example, varicella virus (25) and smallpox virus (26); and ( 3 ) parasitic infections, for example, Paragonimus westermani (27) and Pneumocystis carinii (28) (Table 1). In sarcoidosis, pulmonary calcification can result from either dystrophic calcification or metastatic calcification secondary to hypercalcemia (29,30). Pulmonary vascular calcification (PVC) is postulated to result from shear stress and is considered to be a variant of dystrophic calcification (31).…”

Section: Clinical Classification Of Pulmonary Calcification and Ossifmentioning

confidence: 99%

Calcium Deposition with or without Bone Formation in the Lung

Chan

Morales

Welsh

et al. 2002

Am J Respir Crit Care Med

332

370

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Pulmonary calcification and ossification occurs with a number of systemic and pulmonary conditions. Specific symptoms are often lacking, but calcification may be a marker of disease severity and its chronicity. Pathophysiologic states predisposing to pulmonary calcification and ossification include hypercalcemia, a local alkaline environment, and previous lung injury. Factors such as enhanced alkaline phosphatase activity, active angiogenesis, and mitogenic effects of growth factors may also contribute. The clinical classification of pulmonary calcification includes both metastatic calcification, in which calcium deposits in previously normal lung or dystrophic calcification, which occurs in previously injured lung. Pulmonary ossification can be idiopathic or can result from a variety of underlying pulmonary, cardiac, or extracardiopulmonary disorders. The diagnosis of pulmonary calcification and ossification requires various imaging techniques, including chest radiography, computed tomographic scanning, and bone scintigraphy. Interpretation of the presence of and the specific pattern of calcification or ossification may obviate the need for invasive biopsy. In this review, specific conditions causing pulmonary calcification or ossification that may impact diagnostic and treatment decisions are highlighted. These include metastatic calcification caused by chronic renal failure and orthotopic liver transplantation, dystrophic calcification caused by granulomatous disorders, DNA viruses, parasitic infections, pulmonary amyloidosis, vascular calcification, the idiopathic disorder pulmonary alveolar microlithiasis, and various forms of pulmonary ossification.

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Section: Clinical Classification Of Pulmonary Calcification and Ossifmentioning

confidence: 99%

Calcium Deposition with or without Bone Formation in the Lung

Chan

Morales

Welsh

et al. 2002

Am J Respir Crit Care Med

332

370

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“…Alterations of calcium and phosphorus levels may lead to deposition of calcium crystals in alveolar septa of the lung or in the kidney. Metastatic pulmonary calcification is a rare condition, associated mostly with primary and secondary bone disease, primary and secondary hyperparathyroidism, vitamin-D intoxication, sarcoidosis, chronic renal disease, and malignant diseases [2,6,8,14,17, and reviewed in 21]. Kaltreider et al found 13 cases of interstitial pulmonary calcification in a series of 7221 autopsies [9].…”

Section: Introductionmentioning

confidence: 99%

Reversible metastatic pulmonary calcification in a patient with multiple myeloma

et al. 1996

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A-52-year-old patient presented with a 2-year history of multiple myeloma, recurrent episodes of hypercalcemia, and extensive bone involvement. She developed pulmonary infiltrates, initially misdiagnosed as interstitial pneumonia. High-resolution computed tomography and bone scintiscanning indicated pulmonary calcification, which was confirmed by a transbronchial biopsy. Cytostatic treatment of multiple myeloma in combination with repetitive i.v. administration of bisphosphonates over a period of 6 months led to a significant improvement of clinical symptoms. Regression of pulmonary infiltrates was demonstrated by chest radiograph and computed tomography. There are only a few reports on pulmonary calcification in patients with multiple myeloma; the condition was associated mostly with progressive disease, kidney failure, adult respiratory distress syndrome and bad prognosis. In our patient isolated calcification of the lungs without involvement of other organ systems was successfully treated. These findings suggest that interstitial pulmonary calcinosis in multiple myeloma can be reversed by normalization of serum calcium levels using bisphosphonates combined with cytostatic treatment.

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Sarcoidosis

Sharma¹

1990

Disease-a-Month

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More than a century ago, Jonathan Hutchingson, a surgeon-dermatologist, identified the first case of sarcoidosis at King's College, London. The disease is now known as a commonplace multisystem disorder characterized by the formation of noncaseating granulomata. The diagnosis of sarcoidosis is established by recognizing clinicoradiologic findings and providing histologic evidence of non-caseating granuloma. Serum angiotensin converting enzyme levels are high in about two thirds of the patients and hypercalcemia is a feature in one of every ten victims of sarcoidosis. Immunologic abnormalities include depression of cutaneous delayed-type hypersensitivity, accumulation of T-cells at the site of activity, hyperactive B-cells, and the presence of circulating immune complexes. The course and prognosis of the disease usually correlate with the mode of onset. An acute onset with erythema nodosum indicates a good prognosis and spontaneous resolution; whereas, an insidious onset may be followed by relentless, progressive fibrosis. Mortality and morbidity are caused by pulmonary fibrosis, cardiac arrhythmias, renal failure, neurologic involvement, and blindness. Corticosteroids and chloroquine relieve symptoms and suppress inflammation and granuloma formation.

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Metastatic Pulmonary Calcification in Sarcoidosis

Abstract: A patient with sarcoidosis with elevated 1,25-dihydroxy vitamin D levels, hypercalcemia, nephrolithiasis, and moderate azotemia is presented because of development of metastatic pulmonary calcification which was diagnosed by radioisotope scanning and tissue biopsy

Cited by 4 publications

References 8 publications

Calcium Deposition with or without Bone Formation in the Lung

Calcium Deposition with or without Bone Formation in the Lung

Reversible metastatic pulmonary calcification in a patient with multiple myeloma

Sarcoidosis

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