Tracheobronchial calcification on bronchoscopy in a patient with end stage renal failure: an unusual cause of chronic cough

In this report, we describe a 64 ‐year‐old female with a history of inadequate peritoneal dialysis who presented with severe and persistent chronic cough. Extensive white nodular tracheobronchial mucosal changes were identified on bronchoscopy despite the absence of corresponding abnormalities on CT imaging. We believe that the bronchoscopic findings represent a highly unusual presentation of metastatic pulmonary calcification and an unusual cause of chronic cough amongst patients with end‐stage renal failure. Pulmonary calcification can develop as a complication of end ‐stage renal failure. Most patients are asymptomatic, with characteristic parenchymal changes incidentally detected on computed tomography (CT) imaging and a clinical course that is usually benign. In this report, we describe a 64‐year‐old female with a history of inadequate peritoneal dialysi s who presented with severe chronic cough, a symptom that persisted despite treatment for respiratory tract infection. On follow‐up bronchoscopic examination, white nodular tracheobronchial mucosal changes persisted. The presence of calcium deposits within these nodules was histologically confirme d, although CT imaging had not suggested the presence of calcific tracheobronchial changes. We believe that the bronchoscopic findings represent a highly unusual presentation of metastatic pulmonary calcification and an uncommon cause of chronic cough amongst patients with end‐stage renal failure.

Source: Respirology Case Reports - July 3, 2019 Category: Respiratory Medicine Authors: Alice Sawka, April Crawford, Chen Au Peh, Phan Nguyen Tags: Case Report Source Type: research