Pulmonary Alveolar Microlithiasis and Preterm Delivery: A Case Report

Abstract

Pulmonary alveolar microlithiasis (PAM) is a rare, chronic lung disease characterised by extensive intra-alveolar calcium and phosphorus deposition throughout the parenchyma of both lungs. The etiology and pathogenesis of the disease is unclear. In our case, PAM with pregnancy was presented; respiratory distress had been observed during the first and second trimesters. In the following weeks, premature activity developed and the foetus was not able to stay alive. This is the third case of PAM in pregnancy described in the literature. A 36 year-old female was referred to our emergency department complaining that she had suffered from dyspnoea on a couple of occasions since the first trimestry of her last pregnancy. On suspecting a pulmonary embolism, dynamic thorax multidetector computed tomography (MDCT) was performed after the delivery. MDCT revealed typical PAM findings. In PAM, radiological signs are not compatible with clinical symptoms; thus, the clinical symptoms are not as dramatic as imaging findings. However, it should be taken into consideration that this disease, with no effective treatment, may rarely progress into end stage pulmonary disease due to conditions which alter pulmonary functions, such as pregnancy.

Pulmonary Alveolar Microlithiasis in Pregnancy: A Rare Case Report

“…In such cases, the child is usually delivered prematurely by Caesarean section. [3] and in some cases full term delivery has been reported. It should be considered that this disease with no effective treatment may rarely progress into end-stage pulmonary disease due to conditions which alter pulmonary functions, such as pregnancy.…”

“…[2] Familial cases predominantly affect females, whereas sporadic cases are usually seen in males. [3] The etiopathogenesis is unclear. The present implication for intraalveolar microlith deposition is: Na Pi co-transporter (Npt2b) deletion following defective mutation in the gene "SLC34A2" (In short arm of chromosome 4) in the apical portions of alveolar type II cells.…”