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Respiratory failure due to pulmonary calcification in primary hyperparathyroidism

B Poddar¹, S Bharti¹, V R Parmar¹, R Sidhu², S Chowdhary³, K L N Rao³

¹ Department of Pediatrics, Government Medical College and Hospital, Chandigarh, India
² Department of Radiodiagnosis, Government Medical College and Hospital, Chandigarh
³ Department of Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence to:
Correspondence to:
Dr B Poddar, Reader, Department of Pediatrics, Govt Medical College and Hospital, Sector 32, Chandigarh – 160 030, India;
bananip@hotmail.com

Keywords: respiratory failure; pulmonary calcification; hyperparathyroidism

The first 150 words of the full text of this article appear below.

A 512 year old boy presented with fever, limb pain, polydipsia, and polyuria for 18 months, and respiratory distress for two weeks. His weight and length were below the 5th centile and he had multiple enlarged lymph nodes and hepatosplenomegaly. He was tachypnoeic with retractions, and had bilateral scattered crepitations. A chest x ray showed a dense homogeneous opacity on the left and right hilar prominence, with healed rib fractures. There was cupping and fraying at the ends of long bones, with osteopenia and pencil thinning of cortex. Serum calcium was 2.6 mmol/l, phosphorus 1.48 mmol/l, and alkaline phosphatase 3790 U/l. A presumptive diagnosis of disseminated tuberculosis, rickets, and scurvy was made and he was started on appropriate therapy.

Within a month, he presented with a pathological fracture in the left tibia and worsening respiratory distress. He was emaciated, oxygen dependent, and hypertensive (BP 130/110 mm Hg). Serum calcium . . . [Full text of this article]

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