Vogt K, Oertle D, Keusch G, Koller M
Schweiz Med Wochenschr. 1985 Sep 21;115(38):1288-94.
Case reports on two patients with metastatic pulmonary calcification are presented. Both suffered from long standing chronic renal failure and received immunosuppressive therapy for a (non-functioning) renal transplant. Laboratory tests disclosed hyperphosphatemia and secondary hyperparathyroidism. In the first patient, who presented with "pulmonary edema", the course was rapidly fatal. Diffuse pulmonary calcification was diagnosed only post mortem. Transbronchial biopsy was diagnostic for calcification in the second patient, who had exertional dyspnea and bilateral, asymmetric, interstitial infiltrations on chest X-ray. In patients with chronic renal failure, metastatic calcifications are due not only to disturbances of calcium-phosphate homeostasis but also to other, mostly unknown factors. Diagnostic procedures include biopsy and 99m-technetium-diphosphonate scintigraphy. Prophylaxis of pulmonary calcifications through normalization of serum phosphate and, if indicated, subtotal parathyroidectomy is of the utmost importance as regression of established calcifications rarely occurs.
本文报告了两例转移性肺钙化患者的病例。两名患者均患有长期慢性肾衰竭，并因（无功能的）肾移植接受免疫抑制治疗。实验室检查发现高磷血症和继发性甲状旁腺功能亢进。首例患者表现为“肺水肿”，病程迅速致命，仅在尸检时诊断为弥漫性肺钙化。第二例患者表现为劳力性呼吸困难，胸部X线显示双侧不对称性间质浸润，经支气管活检诊断为钙化。在慢性肾衰竭患者中，转移性钙化不仅归因于钙磷稳态的紊乱，还归因于其他大多未知的因素。诊断程序包括活检和锝-99m二膦酸盐闪烁扫描。通过使血清磷酸盐正常化以及在必要时进行甲状旁腺次全切除术来预防肺钙化至关重要，因为已形成的钙化很少会消退。
