Clinic and radiological improvement of lipoid pneumonia with multiple bronchoalveolar lavages

Abstract

Multiple therapeutic BAL of children with LP results in significant improvement of CT findings, oxygen saturation, restoration of BAL fluid cellularity and clinical recover without any evidence of respiratory distress at the end of treatment and 6 months after the last BAL.

Non-resolving Findings in a Long-term Radiographic Follow-up of an Infant with Acute Paraffin Oil Aspiration

“…In these cases, LP was secondary to mineral oil aspiration, and the delay between aspiration and treatment was 1-60 days. [8] Over a follow-up period of 6 months, complete radiologic resolution was demonstrated in 3 out of 6 patients who had a short interval between intake of mineral oil (1-4 days) and treatment. In the remaining three cases, partial resolution with patchy residual ground glass opacities were seen on CT. All four children with a longer time interval between aspiration of mineral oil and treatment had residual areas of consolidations on CT scans taken at 6-months, but no further follow-up was reported.…”

Exogenous Lipoid Pneumonia Successfully Treated With Bronchoscopic Segmental Lavage Therapy

“…1 There are reports of lipoid pneumonia successfully treated with corticosteroids, 2-4 immunoglobulins, 5 and whole-lung lavage. [6][7][8][9][10] Pulmonary alveolar proteinosis can by treated with multiple segmental or lobar lavages by fiberoptic bronchoscopy using local anesthesia, which could be an alternative to a whole-lung lavage in patients with mild cases of pulmonary alveolar proteinosis. 14 We chose this treatment because we thought that an immunosuppressive agent should be avoided because he suffered from hepatitis B virus infection.…”

“…1 Although there are reports of lipoid pneumonia being successfully treated with corticosteroids, [2][3][4] immunoglobulins, 5 and whole-lung lavage, [6][7][8][9][10] treatment of lipoid pneumonia is not well studied, and the published literature consists only of case reports. We report a case of exogenous lipoid pneumonia successfully treated with bronchoscopic segmental lavage therapy.…”

Lipoid pneumonia: An uncommon entity

“…[52,53] Repeated bronchoalveolar lavage (BAL) with saline has been shown to be an effective therapeutic modality for the treatment of LP. [28] Some researchers successfully used a solution of 0.05% polysorbate 80 in Ringer's lactate as a fat emulsiÞ er for repeated therapeutic BAL. [43] Some authors have described resection of nodules and masses in these cases.…”

“…[24] However, acute presentation with respiratory failure has been reported with accidental/ suicidal massive exposure to mineral oil but not with submassive exposure or inhalation and in children. [25][26][27][28] Laboratory test results are usually normal although leukocytosis and an increased erythrocyte sedimentation rate may occur, especially when complicated by infection.…”