Vaping-Induced Lung Injury: A Case of Lipoid Pneumonia Associated with E-Cigarettes Containing Cannabis.

Bryno Gay,Zachary Field,Mario Madruga,S J Carlan,Rodrigo Murillo Alvarez,Sachin Patel,Wael Nasser

doi:10.1155/2020/7151834

Abstract

Electronic cigarette, or vaping product use-associated lung injury (EVALI), is a group of lung disorders associated with vaping and e-cigarette products that has previously been 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 electronic cigarettes. We explore similarities in the clinical case, define a common clinical presentation with progression of disease, characteristic radiographic findings along with pathological diagnosis and management.

Highlights

Electronic cigarettes were introduced into the United States market in 2007
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 [6]
The presence of lipid-laden macrophages in the sputum or bronchoalveolar lavage (BAL) specimen are consistent with diagnosis of EVALI; high lipidladen macrophages and high lipid-laden alveolar macrophage index (LLAMI) are nonspecific findings and can be found in various lung diseases [15]

Summary

Introduction

Electronic cigarettes were introduced into the United States market in 2007. Since both nicotine-containing electronic cigarettes and cannabis-containing electronic cigarettes have seen a rapid rise in popularity [1, 2]. 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 [6]. A definitive cause is postulated to be a chemical exposure, from substances within the cannabis vape pens [5, 7], the acute incidence of pulmonary disease has brought national attention to this epidemic and warrants a continued investigation into these products, their contents, and medical management for EVALI, especially those purchased from informal sources (i.e., black market products) as reported in the case below. He was discharged on the same regimen for 14 days with follow-up with pulmonology and repeat CT imaging in six weeks

Findings

Discussion

Conclusion