Metastatic Pulmonary Calcification in a Hemodialysis Patient after Renal Transplantation

Vicente R, Santos R, Amoedo M
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Abstract

This is the case of a 64-year-old man, on renal replacement therapy since 2008, due to autosomal dominant polycystic kidney disease. The patient was on peritoneal dialysis from 2008 to 2016, when he underwent renal transplantation. Transplant duration was less than a month due to acute vascular rejection. Since then, he is on hemodialysis. A few months after transplantation, it was incidentally identified confluent bilateral opacities, more prominent on the left lung in a routine X-ray (Figure 1). The patient had made a chest radiography in 2015 without any changes at that time. The CT scan showed parenchymatous densification areas, partially calcified, in both lungs (Figure 2). The patient also developed secondary hyperparathyroidism refractory to medical therapy but refused surgery. Nevertheless, the lesions had a slow progression until the present time.
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肾移植后血液透析患者的转移性肺钙化
这是一例64岁的男性,自2008年以来一直在接受肾脏替代治疗,原因是常染色体显性遗传性多囊肾病。该患者在2008年至2016年接受腹膜透析,当时他接受了肾移植。由于急性血管排斥反应,移植持续时间不到一个月。从那以后,他一直在接受血液透析。移植后几个月,偶然发现合并性双侧混浊,在常规X光检查中左肺更为突出(图1)。该患者在2015年做了胸部X光检查,当时没有任何变化。CT扫描显示两肺实质致密化区域,部分钙化(图2)。患者还出现了继发性甲状旁腺功能亢进症,药物治疗无效,但拒绝手术。然而,直到目前为止,病变进展缓慢。
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