Calcium stone lithoptysis in primary ciliary dyskinesia
| Autor: | Michael R. Knowles, Peadar G. Noone, Marcus P. Kennedy, Paul L. Molina, Andrew J. Ghio, Susan L. Minnix, Johnny L. Carson, Maimoona B Zariwala |
|---|---|
| Rok vydání: | 2007 |
| Předmět: |
Adult
Lung Diseases Male Pulmonary and Respiratory Medicine Pathology medicine.medical_specialty Kartagener's syndrome Calculi 03 medical and health sciences Primary ciliary dyskinesia 0302 clinical medicine medicine Lithoptysis Humans Pseudomonas Infections Prospective Studies 030212 general & internal medicine Prospective cohort study Broncholith Retrospective Studies Bronchiectasis Lung Kartagener Syndrome business.industry Respiratory disease Sputum Middle Aged medicine.disease 3. Good health Radiography medicine.anatomical_structure 030228 respiratory system Dyskinesia Pulmonary calcification Calcium Female medicine.symptom business Calcification |
| Zdroj: | Respiratory Medicine. 101:76-83 |
| ISSN: | 0954-6111 |
| DOI: | 10.1016/j.rmed.2006.04.007 |
| Popis: | Summary Background An association between lithoptysis and primary ciliary dyskinesia (PCD) has not been previously reported. However, reports of lithoptysis from 2 older patients (>60yr) prompted a study of this association. Methods We performed a prospective study of all PCD patients presenting to our institution between August 2003 and March 2006, seeking the symptom of lithoptysis or calcium deposition on radiology. A retrospective analysis of all PCD patients presenting prior to August 2003 was also performed. Patients age⩾40 previously reviewed were recontacted. If a history of lithoptysis or calcium deposition was present, we further reviewed radiographic, microbiologic, and biochemical data, including serum calcium and phosphate. Broncholiths were analyzed by light and electron microscopy- and electron-dispersive X-ray analysis. Results In total, 142 patients ( n = 28 age⩾40) were included, 41 in the prospective and 91 in the retrospective study. Lithoptysis was reported in 5 patients (all age⩾40). Chest CT scans identified calcification (4/5), involving bronchiectatic airways in 3 patients and focal nodular calcification in 1 patient. Two other patients (age 46, 59) were identified with airway calcification without lithoptysis. Available broncholiths from 2 of these patients were composed of calcite, whereas a broncholith from 1 patient with focal nodular calcification contained calcium phosphate. Sputum was positive for Pseudomonas aeruginosa in all 7 patients, but negative for mycobacterial and fungal cultures. Conclusion There is an association between lithoptysis and PCD in patients age⩾40. We hypothesize that calcite stone formation is a biomineralization response to chronic airway inflammation and retention of infected airway secretions in PCD in a subset of PCD patients. |
| Databáze: | OpenAIRE |
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