BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a1155 (Published 13 August 2008) Cite this as: BMJ 2008;337:a1155
  1. Elaine Jolly, specialist registrar,
  2. Paul Warwicker, consultant
  1. 1renal unit, Lister Hospital, Stevenage SG1 4AB
  1. elainejolly{at}yahoo.co.uk

    This chest x ray and subsequent high resolution computed tomography scan of the thorax taken during an admission with sepsis related to a dialysis catheter, showed dramatic and unexpected bilateral metastatic pulmonary calcification. After several years of declining renal function, this 48 year old man had started renal replacement therapy 12 years earlier, with four years of haemodialysis. Pulmonary metastatic calcification is commonly found at post-mortem examination in dialysis patients but rarely presents clinically or radiologically before death. It is poorly understood, but secondary and tertiary hyperparathyroidism, a raised calcium-phosphate product, and acid-base disturbances may be implicated. This patient made a full recovery from sepsis and is currently free of respiratory symptoms.


    Cite this as: BMJ 2008;337:a1155


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