Successful bilateral lung transplantation in pulmonary alveolar microlithiasis: A case report and review of literature

Author:

Mardani Parviz12,Naseri Reyhaneh13,Shahriarirad Reza13ORCID,Mahram Hadiseh4ORCID,Shafi Masoud25,Niknam Tahmoores2,Khosravi Mohammad Bagher6,Fallahi Mohammad Javad7,Amirian Armin1

Affiliation:

1. Thoracic and Vascular Surgery Research Center Shiraz University of Medical Science Shiraz Iran

2. Shiraz Transplant Center, Abu‐Ali Sina Hospital Shiraz University of Medical Sciences Shiraz Iran

3. School of Medicine Shiraz University of Medical Sciences Shiraz Iran

4. Student Research Committee, School of Medicine Shiraz University of Medical Sciences Shiraz Iran

5. Department of Cardiac surgery, Abu Ali Sina Hospital Shiraz University of Medical Sciences Shiraz Iran

6. Anesthesiology and Critical Care Research Center Shiraz University of Medical Sciences Shiraz Iran

7. Department of Internal Medicine Shiraz University of Medical Sciences Shiraz Iran

Abstract

AbstractBackgroundPulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive genetic disorder with approximately 1000 known cases worldwide, in which calcium phosphate microliths deposit in the alveolar air spaces. As of writing this report, no definitive conventional therapy exists, and many PAM cases may progress to severe respiratory failure and potential death. Bilateral lung transplantation (BLx) seems to be the most optimal solution; however, this procedure is challenging along with limited reports regarding the outcome in PAM. We report a case of PAM successfully treated with BLx for the first time in Iran.MethodWe present the case of a 42‐year‐old female with a longstanding history of cough, not responding to conventional antitussive medication, who was diagnosed as a case of PAM following a hospitalization due to coughing, dyspnea on exertion, and hemoptysis. Despite treatment with corticosteroid and medical treatment, no improvement was achieved and she subsequently developed respiratory and right ventricular failure, with oxygen ventilation dependence. Eventually, she was scheduled for BLx. The operation was successful and during her 2‐year follow‐up, no recurrence or significant postoperative complications has been reported.ConclusionThis case presentation and literature review confirm the effectiveness of BLx as a promising treatment for PAM‐diagnosed patients, improving both life expectancy and quality of life.

Publisher

Wiley

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