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Pulmonary alveolar microlithiasis: a rare case report from Syria
Duaa Batesh1, Roaa Habash1, Mhd Nabih Alhaffar2
1Faculty of Medicine, Damascus University.
Introduction And Importance:
This report presents a case of pulmonary alveolar microlithiasis (PAM), a rare disease characterized by dry cough, dyspnea, and chest pain. Most reported cases are from Turkey, with a frequency of 1.85 in 1 million, and there are no documented cases from Syria in the medical literature. Here, we present the first case report from Syria.
Case Presentation:
A 56-year-old male patient complained of a dry cough that began 4 years ago and had worsened over the last 3 months, along with a grade I dyspnea. Chest radiograph showed a 'sandstorm-like' appearance, and a computed tomography scan revealed diffuse ground-glass opacities. To confirm the diagnosis, we performed a transbronchial lung biopsy and bronchial washing. Histopathology results revealed interalveolar calcification consistent with PAM. The diagnosis was based on radiological and lung biopsy findings. The patient received oxygen therapy, resulting in significant improvement. We recommended the use of a home oxygen machine for episodes of shortness of breath.
Clinical Discussion:
PAM is an autosomal recessive disease caused by a mutation in the SLC34A2 gene (solute carrier family 34, member 2 gene), characterized by intra-alveolar airspace microliths called calcospherites. Miliary tuberculosis should be considered a differential diagnosis.
Conclusions:
The disease progresses slowly and is often diagnosed incidentally. Lung transplantation remains the only effective treatment.
Insights
This report details the first case of pulmonary alveolar microlithiasis (PAM) in Syria, a rare lung disease. Early diagnosis and oxygen therapy improved patient symptoms, highlighting the need for broader awareness.
Area of Science:
- Pulmonology
- Rare Diseases
- Medical Case Reports
Background:
- Pulmonary alveolar microlithiasis (PAM) is a rare, autosomal recessive lung disease characterized by intra-alveolar calcifications.
- Most documented cases originate from Turkey, with limited reported incidence globally.
- No prior cases of PAM have been documented in the Syrian medical literature.
Observation:
- A 56-year-old male presented with a four-year history of dry cough and worsening dyspnea.
- Radiological imaging revealed a 'sandstorm-like' appearance and diffuse ground-glass opacities.
- Transbronchial lung biopsy confirmed interalveolar calcification, consistent with PAM.
Findings:
- The diagnosis of PAM was confirmed through characteristic radiological and histopathological findings.
- The patient experienced significant improvement with oxygen therapy.
- Home oxygen support was recommended for managing shortness of breath.
Implications:
- This case report marks the first documented instance of PAM in Syria.
- It underscores the importance of recognizing rare lung diseases in diverse geographical regions.
- While lung transplantation is the only definitive treatment, supportive care can improve patient quality of life.
