A case report of exogenous lipoid pneumonia associated with avocado/soybean unsaponifiables

Jacques Boutros,Bernard Padovani,Charles-Hugo Marquette,Jonathan Benzaquen,Michael Levraut,Fanny Rocher,Véronique Hofman,Marine Muzzone,Yann Diascorn,Sylvie Leroy

doi:10.1186/s12890-019-0997-1

Abstract

BackgroundExogenous lipoid pneumonia is a rare disease resulting from intra-alveolar accumulation of lipids of mineral, vegetal, or animal origin, that induce a foreign body type of inflammatory reaction in the lungs. Gastroesophageal reflux disease and other esophageal abnormalities have often been associated with this disease.Case presentationWe herein report the case of an 83-year-old patient in whom a follow-up chest computed tomography scan, for a lingular consolidation, showed multifocal ground glass and consolidative opacities with areas of low attenuation, suggestive of exogenous lipid pneumonia. The patient had been on piascledine capsules (avocado/soybean unsaponifiables) for 20 years and had a hiatal hernia with documented gastroesophageal reflux disease. After thorough history taking, no other predisposing factors were found. The diagnosis was confirmed using oil red staining of bronchoalveolar lavage showing lipid-laden macrophages and extracellular lipid droplets.ConclusionsTo our knowledge, this is the first case of ELP secondary to avocado/soybean unsaponifiables in the literature.

Highlights

Exogenous lipoid pneumonia is a rare disease resulting from intra-alveolar accumulation of lipids of mineral, vegetal, or animal origin, that induce a foreign body type of inflammatory reaction in the lungs
To our knowledge, this is the first case of Exogenous lipoid pneumonia (ELP) secondary to avocado/soybean unsaponifiables in the literature
Exogenous lipoid pneumonia (ELP) is a rare lung condition due to the inflammatory reaction generated by the presence of foreign fatty substances in the alveoli

Summary

Introduction

Exogenous lipoid pneumonia is a rare disease resulting from intra-alveolar accumulation of lipids of mineral, vegetal, or animal origin, that induce a foreign body type of inflammatory reaction in the lungs. ELP can be suspected when a clinical history of inhalation or aspiration of fatty substances and chest imaging are compatible [1,2,3]. We present an unusual case of ELP caused by avocado/ soy unsaponifiables (ASU). The PET/CT scan (Fig. 1) performed in 2015 showed no abnormal metabolic activity.

Results

Conclusion