Vaping Induced Pathological Changes in the Lung-A Case Report Study

Rashmi R Bhuyan,Kumkum Vadera

doi:10.31579/2640-1053/103

Abstract

Vaping associated pulmonary injury (VAPI), a group of respiratory symptoms, sometimes accompanied by non-specific symptoms like generalized fatigue, body ache, fever, nausea, diarrhea, vomiting and chills that has been previously categorized as a diagnosis of exclusion and best described as an exogenous lipoid pneumonia, or chemical pneumonitis. Here we describe the onset of an exogenous cause of lipoid pneumonia in an otherwise healthy patient using cannabis-containing products. We explore, similarities in the clinical case, identify common clinical features, characteristic radiologic findings along with cytological changes in the lungs.

Highlights

The outbreak of severe and acute pulmonary disease associated with the use of cannabis extract-containing vape pens and nicotine e-cigarettes has grown to 2,711 reported cases according to the most up-to-date data retrieved from the Center for Disease Control and Prevention (CDC) website posted on January 20, 2020 [1]. 27 confirmed death cases have been reported due to severe and acute pulmonary disease associated with e-cigarettes in all 50 states, the District of Columbia, and two U.S territories (Puerto Rico and the U.S Virgin Islands) [1]
Chemical exposure has been postulated as a definitive cause, the acute incidence of pulmonary disease has brought national attention to this epidemic (2) and warrants more studies of clinical course, radiological findings and unique pathological changes in the lungs that will help in immediate medical management for Vaping associated pulmonary injury (VAPI) with appropriate support, as reported in the case below
Differential diagnosis initially in the emergency department made were interstitial pneumonia vs multifocal pneumonia; VAPI was considered after cytology finding of lipid-laden macrophages in the bronchoalveolar lavage by bronchoscopy procedure was observed

Summary

Introduction

The outbreak of severe and acute pulmonary disease associated with the use of cannabis extract-containing vape pens and nicotine e-cigarettes has grown to 2,711 reported cases according to the most up-to-date data retrieved from the Center for Disease Control and Prevention (CDC) website posted on January 20, 2020 [1]. 27 confirmed death cases have been reported due to severe and acute pulmonary disease associated with e-cigarettes in all 50 states, the District of Columbia, and two U.S territories (Puerto Rico and the U.S Virgin Islands) [1]. chemical exposure has been postulated as a definitive cause, the acute incidence of pulmonary disease has brought national attention to this epidemic (2) and warrants more studies of clinical course, radiological findings and unique pathological changes in the lungs that will help in immediate medical management for VAPI with appropriate support, as reported in the case below.A 30 year old female with history of anxiety, depression and marijuana use presented in the ED with dyspnea and hypoxic respiratory failure with presumed etiology of inhalation of injury vs hypersensitivity pneumonia. The outbreak of severe and acute pulmonary disease associated with the use of cannabis extract-containing vape pens and nicotine e-cigarettes has grown to 2,711 reported cases according to the most up-to-date data retrieved from the Center for Disease Control and Prevention (CDC) website posted on January 20, 2020 [1]. Chemical exposure has been postulated as a definitive cause, the acute incidence of pulmonary disease has brought national attention to this epidemic (2) and warrants more studies of clinical course, radiological findings and unique pathological changes in the lungs that will help in immediate medical management for VAPI with appropriate support, as reported in the case below.

Results

Conclusion