Tracheobronchial calcification on bronchoscopy in a patient with end stage renal failure: an unusual cause of chronic cough

Pulmonary calcification can develop as a complication of end-stage renal failure. Most patients are asymptomatic, with characteristic parenchymal changes incidentally detected on computed tomography (CT) imaging and a clinical course that is usually benign. In this report, we describe a 64-year-old female with a history of inadequate peritoneal dialysis who presented with severe chronic cough, a symptom that persisted despite treatment for respiratory tract infection. On follow-up bronchoscopic examination, white nodular tracheobronchial mucosal changes persisted. The presence of calcium deposits within these nodules was histologically confirmed, although CT imaging had not suggested the presence of calcific tracheobronchial changes. We believe that the bronchoscopic findings represent a highly unusual presentation of metastatic pulmonary calcification and an uncommon cause of chronic cough amongst patients with end-stage renal failure.