Bone scintigraphy in two siblings with pulmonary alveolar microlithiasis

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Abstract
Pulmonary alveolar microlithiasis (PAM), is a rare disorder of unknown aetiology, characterised by the formation of tiny calcium phosphate calculi in the pulmonary alveoli (Prakash et al, 1983). About 50% of the cases are familial, mainly in siblings (Sosman et al, 1957) and the disease is usually diagnosed incidentally by the characteristic chest X-ray findings. Patients generally remain asymptomatic for many years, but most eventually develop restrictive lung disease and a few die as a result of severe hypoxaemia and cor pulmonale (Prakash et al, 1983; Sosman et al, 1957). The typical radionuclide appearance of PAM, using 99Tcm-MDP scintigraphy of chest, has been described only twice (Brown et al, 1978; Shigeno et al, 1982). This is the first description of the typical scintigraphic pattern of PAM in two siblings, one of them asymptomatic. The use of radiography in conjunction with scintigraphy for the early diagnosis of PAM in asymptomatic relatives of patients with PAM, is suggested.

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