We read with great interest the case report by Jiménez Romero et al. on pulmonary alveolar microlithiasis (PAM) published in Open Respiratory Archives.1 The authors elegantly describe the clinical, radiological, and histopathological spectrum of this rare disorder, underlining its genetic basis in SLC34A2 mutations and the natural course of progressive respiratory decline. Their conclusions underscore the diagnostic challenges and the lack of curative therapies. However, we wish to draw attention to an overlooked but significant contribution from the literature. In 1996, the first clinical case of single lung transplantation for PAM was reported by our group, published in the Saudi Journal of Kidney Diseases and Transplantation.2 That report remains of historic importance as the first documented transplant in PAM. This milestone underscores that while supportive measures and emerging molecular insights are valuable, lung transplantation continues to represent the only definitive therapeutic option for advanced PAM. Shaw et al.3 have recently expanded the pathophysiological framework of PAM by framing it as a disorder of pulmonary phosphate homeostasis, thereby providing a unifying mechanistic explanation for microlith accumulation. Their work complements clinical reports by stressing potential future targets for disease-modifying therapies. These three key contributions, the present case report, our early transplant experience, and the recent pathophysiological insights, should be viewed as complementary steps in shaping a more comprehensive understanding of PAM. We encourage future authors to integrate both historical and contemporary perspectives when discussing rare diseases, to ensure that current advances are interpreted within their broader scientific context.
Declaration of generative AI and AI-assisted technologies in the writing processChat GPT was used for linguistic and grammar reasons to ease readability and was revised.
FundingNone declared.
Authors’ contributionsThe corresponding author is in charge of conceptualization and writing.
Conflicts of interestNone declared.
