Metastatic pulmonary calcification in a dialysis patient

Pulmonary metastatic calcification associated with uremic patients is a com plication of hyperparatiroidism characterized by deposits of calcium salts in alveolar walls, generally slowly progressive and often asymptomatic. We describe a patient undergoing long-term hemodialysis with severe secondary hyperparathyroidism, pulmonary infiltrates of calcium density of chest-x-ra y, abnormal pulmonary diffusing capacity and positive technetium 99m diphos phonate (99m Tc-DPN) lung scan. Bacteriologic studies in bronchoalveolar la vage were negative. Lung biopsy showed diffuse septal calcification with fi brosis and immunofluorescence was negative. The evolution was unfavorable d espite treatment. We review physiological, clinical, diagnostic and therape utic aspects in order to a better understand this illness.