Review of Cases of E-Cigarette or Vaping Product Use-Associated Lung Injury (EVALI) and Brief Review of the Literature.

Amr Essa,Venketraman Sahasranaman,Michael Kaster,Matthew Kruse,Douglas Moore,Nikhil Jagan,Stanley Thomas,Shraddha Narechania,Jeffrey Macaraeg,Saboor Randhawa,Manasa Velagapudi,Daniel Kwon,Carrie Valenta,John Horne

doi:10.1155/2020/1090629

Abstract

Since the appearance of the E-Cigarette in the early 2000s, its industry, popularity, and prevalence have risen dramatically. In the past, E-Cigarette use with the vaping of nicotine or cannabis products had been associated with a few reported cases of lung injury. However, in 2019, thousands of cases of E-Cigarette or vaping product use-associated lung injury (EVALI) were reported in the United States. Evidence linked this outbreak with vaping of tetrahydrocannabinol (THC). We report two confirmed cases of EVALI and their associated clinical, radiologic, and pathologic features. This report supports the growing body of information regarding EVALI. It also discusses various substances, particularly vitamin E acetate, which has been suggested as a causative agent.

Highlights

The E-Cigarette is a battery-operated device used to produce an aerosol that is inhaled into the lungs, the composition of which is determined by the content of the E-Liquid
The increasing mortality and associated morbidity catapulted it to national attention and led to the coining of the term E-Cigarette or vaping product use-associated lung injury (EVALI) [6]
A subsequent computed tomography (CT) scan of the chest revealed extensive symmetric ground-glass opacities in all lobes with interlobular septal thickening and subpleural sparing (Figures 2 and 3). He was started on broad-spectrum antimicrobial therapy with azithromycin, ceftriaxone, and levofloxacin to treat potentially bacterial pneumonia, all of which was discontinued after cultures were sterile (Table 1)

Summary

Introduction

The E-Cigarette is a battery-operated device used to produce an aerosol that is inhaled into the lungs, the composition of which is determined by the content of the E-Liquid. It usually delivers nicotine; it can be used to deliver other substances such as tetrahydrocannabinol (THC), cannabidiol (CBD), and butane hash oils [1]. Since the introduction of E-Cigarette into the US market in 2007, there have been a few published and documented cases which describe lung disease in relation to vaping of nicotine or extracts of cannabis, with the earliest documented in 2012 [2,3,4,5]. We further discuss the clinical, radiologic, and pathologic features, with a brief review of the current body of published literature

Case Presentation

Findings

Discussion

Conclusion