WCIM 2014 SEOUL KOREA 465
Poster Session
The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
PS 1625 Miscellaneous
A Case of Diffuse Pulmonary Ossifi cation in a Chronic Hemodialysis Patient
Yong Dae Lee1, So Yeon Lee1, Keum Ju Choi1, Seung Soo Yoo1, Shin Yup Lee1, Jaehee Lee1, Seung Ick Cha1, Jae Yong Park1, Chang Ho Kim1
Department of Internal Medicine, Kyungpook National University School of Medicine, Korea1
Diffuse pulmonary ossifi cation (DPO) is a rare condition characterized by chronic met- aplastic ossifi cation of the lung parenchyma. DPO may be associated with underlying lung, heart, or metabolic problems, or may be idiopathic. To our knowledge, very few cases of DPO in the setting of end stage renal disease (ESRD) have been reported to date. Here we report a case of nodular DPO in an ESRD patient on hemodialysis. A 33-year-old male presented with a 4-year history of occasional blood-tinged sputum.
Physical examination was unremarkable except for mild pallor of his conjunctivae. He was on medications for hypertension, gout, and chronic kidney disease (CKD). He had also been receiving hemodialysis for 7 years. The blood tests showed a hemoglobin level of 8.7 g/dl, a calcium of 9.0 mg/dl, and a phosphorus of 4.7 mg/dl. Chest X-ray showed bilateral diffuse micronodular opacities and high resolution computed tomog- raphy scans revealed diffuse tiny nodules, interstitial thickening, and parenchymal fi brotic bands in both lungs. Transthoracic echocardiography revealed a mildly dilated left atrium (42 mm), but otherwise unremarkable. Wedge resection of the right lower lobe was performed through video-assisted thoracic surgery and microscopic exam- ination revealed nodular DPO.
