Exogenous lipoid pneumonia induced by nasal decongestant

Osman, Giorgia Amira; Rícci, Alberto; Terzo, Fabrizio; Falasca, Carlo; Giovagnoli, Maria Rosaria; Bruno, Pierdonato; Vecchione, Andrea; Raffa, Salvatore; Valente, Sabatino; Torrisi, Maria Rosaria; Dominicis, Chiara De; Giovagnoli, Simonetta; Mariotta, Salvatore

doi:10.1111/crj.12557

Cited by 16 publications

(14 citation statements)

References 14 publications

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“…In the presented woman, the first suggestion concerning the fatty-like character of pulmonary opacities came from chest CT description. Similarly to our case, the most frequent radiologic manifestations described in the patients with lipoid pneumonia, are ground-glass opacities and consolidations involving one or more segments, typically with peribronchovascular distribution and predominant location in both lower lobes, with the adipose density (between -150 and -30 HU), which can be found in 70-80% of patients [6,8]. Other described forms are nodules and masses with irregular margins, which may be misdiagnosed as lung cancer [3,6].…”

Section: Discussionsupporting

confidence: 78%

“…The confirmation of diagnosis, next to the radiological finding, may be achieved by demonstration of lipid-laden macrophages in BAL, in a patient with the history of lipid exposure. To verify the diagnosis, staining specific for lipids is often necessary [3,6,8,9]. If the triad of history of mineral-oil ingestion, imaging finding and BAL finding are not decisive, transthoracic fineneedle biopsy, transbronchial lung biopsy may be required.…”

Section: Discussionmentioning

confidence: 99%

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Exogenous Lipoid Pneumonia Induced by Nasal Instillation of Paraffin Oil

Bartosiewicz¹,

Zimna²,

Lewandowska³

et al. 2020

Advances in Respiratory Medicine

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Lipoid pneumonia is a rare pulmonary disease, classified in terms of the source of lipid exposure into two variants: exogenous and endogenous. We present a patient with exogenous lipoid pneumonia, acquired after chronic exposure to paraffin oil-containing nasal drops. The diagnosis was established by demonstration of lipid-laden macrophages in bronchoalveolar lavage, chest computed tomography results and a history of lipid exposure.

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Exogenous Lipoid Pneumonia Induced by Nasal Instillation of Paraffin Oil

Bartosiewicz¹,

Zimna²,

Lewandowska³

et al. 2020

Advances in Respiratory Medicine

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“…Historically, cytology-based studies utilizing Oil Red O staining have been used to demonstrate the presence of lipid-laden macrophages in the lung (7,11,14,15) There are limited ultrastructural studies showing lipid-like cytosolic inclusions in lung macrophages from BAL uid. M. tuberculosis infection studies (16,17), mineral oil-exposure related (18,19) or petroleum aspiration (20) reports come closest to describing similar inclusions, nonetheless these structures are clearly not the heterogeneous structures we have observed here in the vaping subject.…”

Section: Discussionsupporting

confidence: 48%

Lung Macrophages Accumulate Novel Cytosolic Inclusions With Vaping: A Case Report From an Asymptomatic Habitual Vaper

Armstrong

Stan

Dessaint

et al. 2020

Preprint

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Background: The effects of habitual vaping on lung health are currently unknown. Acute e-cigarette/vaping product use-associated lung injury (EVALI) has been highlighted recently in numerous cases across the U.S. Several EVALI case reports highlight alterations in lung macrophages, justifying investigation of this key immune sentinel of the lung in habitual vape device users. Methods: Histologic (Oil Red O stain) and transmission electron microscopy were used to evaluate BAL macrophages obtained from a habitual and asymptomatic 25-year-old female vaper. Results: Oil Red O stain evaluation of BAL macrophages demonstrate a prevalence of cells with high lipid accumulation in multiple, discrete cytoplasmic foci. At ultrastructural level, this translated in membrane-bound compartments filled with osmiophilic material of various densities segregated along curved phase separation lines reminiscent of suspensions of immiscible fluids. Conclusions: This ultrastructural pattern is unlike any other previously reported in aspiration syndromes and may represent a defining diagnostic feature of vapers.

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“…Amiodaron wurde dabei durch Digoxin ersetzt. Die meisten berichteten Fälle von Lipidpneumonie, die als exogen bedingt diagnostiziert werden, sind Folge einer Aspiration oder Inhalation von Mineralölen oder pflanzlichen Ölen [3,11]. Die Lipidpneumonie tritt überwiegend bei älteren Menschen sowie bei Kindern mit Entwicklungsstörungen auf, vermutlich weil diese Gruppen eher zur Aspiration neigen [15].…”

Section: Einführungunclassified

“…In der Literatur wurde zudem berichtet, dass die Computer- und Magnetresonanztomografie in der Lage sind, Fett im Lungengewebe nachzuweisen. Zu den am häufigsten beschriebenen Merkmalen gehören alveoläre Konsolidierungen von geringer Abschwächung, Milchglastrübungen mit Verdickung der intralobulären Septen («Crazy-Paving»-Muster) oder alveoläre Knötchen [2,6,7,8,11]. …”

Section: Diskussionunclassified

Ein seltener Fall von Lipidpneumonie durch Amiodaron

Voulgareli¹,

Chronaiou²,

Tsoukalas³

et al. 2019

Kompass Pneumol

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Wir berichten über einen Fall endogener Lipidpneumonie infolge Langzeitanwendung (≥ 30 Jahre) von Amiodaron zur Behandlung von Vorhofflimmern bei einer 76-jährigen Patientin kaukasischer Abstammung, die sich mit Husten und Dyspnoe bei uns vorstellte. Die endogene Lipidpneumonie ist eine seltene und unterdiagnostizierte Krankheit, die häufiger bei Erwachsenen auftritt. Sie verläuft normalerweise asymptomatisch und wird meist bei Patienten diagnostiziert, die klinisch instabil geworden sind, oder wenn im Thoraxröntgenbild eine abnorme Verschattung der Lunge erkennbar ist. In dem hier vorgestellten Fall erfolgte die Diagnosestellung durch fiberoptische Bronchoskopie mit Gewinnung von Flüssigkeit nach bronchoalveolärer Lavage (BALF), in der fettbeladene Makrophagen (Oil-Red-O-Färbung) zu finden waren. Da die Anwendung ölhaltiger Produkte anamnestisch ausgeschlossen worden war, wurde Amiodaron für die wahrscheinlichste Ursache der Lipidpneumonie gehalten. Die Behandlung wurde von Amiodaron auf Digoxin umgestellt und die Patientin erhielt oral Prednisolon. Während der 2-jährigen Nachbeobachtungsdauer blieb die Patientin klinisch stabil und die radiologischen Zeichen gingen zurück.

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Exogenous lipoid pneumonia induced by nasal decongestant

Cited by 16 publications

References 14 publications

Exogenous Lipoid Pneumonia Induced by Nasal Instillation of Paraffin Oil

Exogenous Lipoid Pneumonia Induced by Nasal Instillation of Paraffin Oil

Lung Macrophages Accumulate Novel Cytosolic Inclusions With Vaping: A Case Report From an Asymptomatic Habitual Vaper

Ein seltener Fall von Lipidpneumonie durch Amiodaron

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