Metastatic pulmonary calcifications postcardiac transplant in a 15-year-old patient: A case report and review of literature

• Main Authors: Dana AlNuaimi, MD, Mahmoud ElKaissi, MD, Ali Wahla, MD, Irfan Shafiq, MD, Shareefa Abdulghaffar, MD
• Format: Article
• Language: English
• Published: Elsevier 2020-10-01
• Series: Radiology Case Reports
• Subjects: Metastatic pulmonary calcification; Congenital heart disease; Cardiac transplant; Chest radiography; Computed tomography; Metabolic disease
• Online Access: http://www.sciencedirect.com/science/article/pii/S193004332030368X

Metastatic pulmonary calcification is a metabolic lung disease that occurs due to a prolonged hypercalcemic state where calcium salts precipitate into numerous foci or nodules of fluffy calcifications in the lung apices, usually bilaterally. Calcifications can also occur in other organs such as in the stomach and the kidneys. It is often underdiagnosed and is usually associated with end stage renal failure and resultant secondary hyperparathyroidism. Nevertheless, it is rarely reported in the postcardiac surgery status and cardiac transplant patients. We present a case of a 15-year-old male patient with a recent history of cardiac transplant due to a complex congenital heart disease where findings of extensive metastatic pulmonary calcifications were seen a routine follow-up chest radiograph. Clinical manifestations of metastatic pulmonary calcifications can range from having no symptoms or mild dyspnea on exertion to fulminant respiratory failure. Therefore, early recognition of imaging features and initiation of proper management is crucial to the patient's outcome.