{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2022,3,31]],"date-time":"2022-03-31T16:29:55Z","timestamp":1648744195395},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Eine 70-j\u00e4hrige Patientin, die vor ca. 20 Jahren aufgrund einer Anti-Neutrophile cytoplasmatische Antik\u00f6rper (ANCA)-positiven, rapid-progressiven Glomerulonephritis eine Nierentransplantation erhielt, wurde uns zur Abkl\u00e4rung einer fibrosierenden interstitiellen Lungenerkrankung mit Computertomografie (CT)-radiologischen Ver\u00e4nderungen im Sinne (i.\u200aS.) einer akuten Alveolitis zugewiesen. Sie beklagte eine bereits seit L\u00e4ngerem bestehende Belastungsdyspnoe. Lungenfunktionell zeigte sich eine leichte Restriktion (FVC 78\u200a% d. Soll), ausgepr\u00e4gt eine schwere Diffusionsst\u00f6rung (DLCO 41\u200a% d. Soll). Sowohl anamnestisch als auch serologisch ergab sich kein Hinweis auf eine exogen-allergische Alveolitis. In den bronchoskopisch gewonnenen Proben wurden initial Ver\u00e4nderungen i.\u200aS.\u200aeiner nichtspezifischen interstitiellen Lungenerkrankung vom fibrotischen Typ, z.\u200aB. zu einer Reaktion im Rahmen der immunsuppressiven Therapie passend, gefunden. Mikrobiologisch wurde in der bronchoalveol\u00e4ren Lavage (BAL)-Fl\u00fcssigkeit Herpes-simplex-Virus mittels Polymerase-Kettenreaktion (PCR) nachgewiesen. Unter der Arbeitsdiagnose einer Herpes-Pneumonitis wurde eine antivirale Therapie durchgef\u00fchrt. Die immunsuppressive Therapie wurde fortgesetzt. In einer Kontrolle konnte der Herpesvirus nicht mehr nachgewiesen werden. Nach initialer subjektiver Verbesserung der Luftnot und wiederholter Kontroll-CT-Bildgebung stellten sich die initialen radiologischen Ver\u00e4nderung nach ca. einem Jahr als unver\u00e4ndert dar und die Belastungsluftnot als persistierend. In der neuerlichen transbronchialen Lungenbiopsie konnte eine metastatische pulmonale Kalzifikation nachgewiesen werden. Eine Aktivit\u00e4t der Erkrankung konnte erfreulicherweise ausgeschlossen werden.<\/jats:p><jats:p>\n          Fazit\u2002In der differenzialdiagnostischen Abkl\u00e4rung interstitieller Lungenerkrankungen muss v.\u200aa. bei Patient*innen mit vulnerablem Kalzium-Phosphat-Haushalt und S\u00e4ure-Basen-Gleichgewicht, wie es z.\u200aB. im Rahmen chronischer Nierenerkrankungen auftritt, auch an die M\u00f6glichkeit einer metastatischen pulmonalen Kalzifikation (MPC) gedacht werden, v.\u200aa. wenn das radiologische Bild persistierende, oberlappenbetonte Milchglasver\u00e4nderungen aufzeigt. Die Diagnosestellung erfordert hierbei eine multidisziplin\u00e4re Zusammenarbeit zwischen Pneumologen, Radiologen und Pathologen.<\/jats:p>","DOI":"10.1055\/a-1482-2403","type":"journal-article","created":{"date-parts":[[2021,5,11]],"date-time":"2021-05-11T23:03:30Z","timestamp":1620774210000},"page":"864-868","source":"Crossref","is-referenced-by-count":0,"title":["Metastatische pulmonale Kalzifikation \u2013 eine selten diagnostizierte Entit\u00e4t in der differenzialdiagnostischen Abkl\u00e4rung interstitieller Lungenerkrankungen"],"prefix":"10.1055","volume":"75","author":[{"given":"T.","family":"Gro\u00df","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin, Sektion Pneumologie, Bundeswehrkrankenhaus Westerstede"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Woziwodski","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Aurich"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Simka","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr diagnostische und interventionelle Radiologie, Ammerlandklinik Westerstede"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,5,11]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1097\/MCP.0b013e328363f48d","article-title":"Update on the diagnosis and classification of ILD","volume":"19","author":"C J Ryerson","year":"2013","journal-title":"Curr Opin Pulm Med"},{"issue":"S 05","key":"ref2","first-page":"v1","article-title":"Interstitial lung disease guideline: the British Thoracic Society in collaboration with the Thoracic Society of Australia and New Zealand and the Irish Thoracic Society","volume":"63","author":"B 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