Pulmonary Alveolar Microlithiasis: A Rare Genetic Lung Disease Mistaken for Miliary Tuberculosis—A Case Report

Tuberculosis is the initial etiology considered during evaluation of miliary opacities on chest radiograph in endemic regions. Further characterization of opacities requires performing a thin-section computed tomography (CT) scan. Here, we report a case of pulmonary alveolar microlithiasis (PAM) in a 35-year-old lady with respiratory symptoms. She was initially diagnosed as miliary tuberculosis and was prescribed antitubercular therapy, without any clinical relief. We considered the probability of PAM after performing a CT scan, which showed interstitial septal thickening and dense pleuropulmonary calcifications. The diagnosis was confirmed by whole-exome sequencing, which revealed a homozygous mutation in the <i>SLC34A2</i> gene (c.675G>A). The need for physicians to be aware of the classic presentation of such a rare disease is highlighted in this case. How to cite this article: Satuluri SP, Kodati R, Narahari NK, <i>et al.</i> Pulmonary Alveolar Microlithiasis: A Rare Genetic Lung Disease Mistaken for Miliary Tuberculosis —A Case Report. Indian J Respir Care 2025;14(2):127–129.