Vaping-related Lung Injury in an Adolescent

Lu, Monica; Jabre, Nicholas A.; Mogayzel, Peter J.

doi:10.1164/rccm.201909-1786im

Cited by 11 publications

(10 citation statements)

References 2 publications

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“…Contributing susceptibility factors for EVALI pathogenesis may include genetic, environmental, lifestyle factors and concomitant diseases as not all THC-cartridge users were hospitalized for EVALI [24]. The use of other vaping products, such as flavored e-liquids and pods with nicotine salts, can be contributing and exacerbating factors in the pathogenesis of EVALI [3,25].…”

Section: Discussionmentioning

confidence: 99%

“…By December 2019, there have been over 2,500 hospitalized EVALI patients, most of whom are men younger than 35 years of age [1]. Patients hospitalized with EVALI have manifested a variety of radiological imaging patterns consistent with lipoid pneumonia, eosinophilic pneumonia, and chemical damage to the lung tissue [2,3]. Patients diagnosed with this illness have reported symptoms, such as a cough, shortness of breath, chest pain, nausea, vomiting, diarrhea, fatigue, fever, or weight loss [4].…”

Section: Introductionmentioning

confidence: 99%

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Chemical Constituents Involved in E-Cigarette, or Vaping Product Use-Associated Lung Injury (EVALI)

Muthumalage

Friedman

McGraw

et al. 2020

Toxics

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The Centers for Disease Control declared e-cigarette, or vaping, product use-associated lung injury (EVALI) a national outbreak due to the high incidence of emergency department admissions and deaths. We have identified chemical constituents in e-cig counterfeit cartridges and compared these to medical-grade and CBD containing cartridges. Apart from vitamin E acetate (VEA) and tetrahydrocannabinol (THC), other potential toxicants were identified including solvent-derived hydrocarbons, silicon conjugated compounds, various terpenes, pesticides/plasticizers/polycaprolactones, and metals. This study provides additional insights into the chemicals associated with EVALI cartridges and thus may contribute to the underlying disease mechanism of acute lung injury.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Chemical Constituents Involved in E-Cigarette, or Vaping Product Use-Associated Lung Injury (EVALI)

Muthumalage

Friedman

McGraw

et al. 2020

Toxics

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“…Most common diagnosis was EVALI (n = 15) [26][27][28][29][30][31][32][33][34][35][36] or EVALI with an additional finding (n = 1) [37]. Second most common diagnosis included either organizing pneumonia/ Bronchiolitis obliterans with organizing pneumonia (BOOP)/ respiratory bronchiolitis (n = 12) [38][39][40][41][42][43][44][45][46] or lipoid pneumonia (n = 9) [11,[47][48][49][50][51]. In 4 cases vaping precipitated a pneumothorax [52][53][54] and in 2 exacerbated pre-existing asthma [55].…”

Section: Classification Of Casesmentioning

confidence: 99%

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Tzortzi

Kapetanstrataki

Evangelopoulou

et al. 2020

IJERPH

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Following the recent electronic cigarette (e-cigarette) illness outbreak, the current review aimed to collect all related clinical cases for study and analysis and provide a critical synopsis of the proposed injury mechanism. Adhering to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) guidelines, e-cigarette-related clinical cases were identified via Google Scholar and PubMed databases. Additionally, references of published case reports and previous review papers were manually searched, revealing 159 publications presenting e-cigarette-related case reports and 19 reports by the Centers for Disease Control and Prevention. 238 individual cases were identified; 53% traumatic injuries due to e-cigarette explosion or self-combustion, 24% respiratory cases, and 12% poisonings. Additional cases pertained to oral, cardiovascular, immunologic, hematologic, allergic reactions, infant complications, and altered medication levels. Case reports were mainly published between 2016–2019 (78%). The oldest case, a lipoid pneumonia, was published in 2012. The current review showed that e-cigarette-related health effects extend beyond the acute lung injury syndrome, including traumatic, thermal injuries and acute intoxications. Physicians should be aware of the distinct clinical presentations and be trained to respond and treat effectively. Regulators and public health authorities should address the regulatory gap regarding electronic nicotine delivery systems (ENDS) and novel tobacco products.

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“…Contributing susceptibility factors for EVALI pathogenesis may include genetic, environmental, lifestyle factors and concomitant diseases as not all THC-cartridge users were hospitalized for EVALI (Chatham-Stephens et al 2019). The use of other vaping products, such as flavored e-liquids and pods with nicotine salts can be contributing and exacerbation factors to the pathogenesis of EVALI (Balmes 2020; Lu et al 2020).…”

Section: Discussionmentioning

confidence: 99%

“…By December 2019, there have been over 2,500 hospitalized EVALI patients, most of whom are men younger than 35 years of age (Hartnett et al 2019). Patients hospitalized with EVALI have manifested several radiological imaging patterns, such as lipoid pneumonia, eosinophilic pneumonia, and chemical damage to the lung tissue (Henry et al 2019; Lu et al 2020). Patients diagnosed with this illness have reported symptoms, such as cough, shortness of breath, or chest pain, nausea, vomiting, or diarrhea fatigue, fever, or weight loss (Kalininskiy et al 2019).…”

Section: Introductionmentioning

confidence: 99%

Chemical constituents involved in e-cigarette, or vaping product use-associated lung injury (EVALI)

Muthumalage

Friedman

McGraw

et al. 2020

Preprint

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AbstractBackgroundThe Centers for Disease Control (CDC) declared e-cigarette (e-cig), or vaping product use-associated lung injury (EVALI) a national outbreak due to the high incidence of emergency department admissions and deaths. Investigators have identified vitamin E acetate (VEA) as the plausible cause for EVALI, based on compounds found in bronchoalveolar lavage fluid.ObjectivesWe defined the chemical constituents present in e-cig cartridges associated with EVALI and compared constituents to medical-grade and cannabidiol (CBD) containing cartridges.MethodsWe measured chemicals and elemental metals in e-liquid and vapor phases of e-cig counterfeit cartridges by Gas Chromatography (GC) and Mass Spectrometry (MS), EPA method TO-15 by GCMS, and ICP-MS analysis.ResultsWe have identified chemical constituents in e-cig vaping tetrahydrocannabinol (THC)-containing counterfeit cartridges compared to medical-grade and cannabidiol (CBD) containing cartridges. Apart from VEA and THC, other potential toxicants correlated with EVALI included solvent-derived hydrocarbons, silicon conjugated compounds, various terpenes, pesticides/plasticizers/polycaprolactones, and metals. These chemicals are known to cause symptoms, such as cough, shortness of breath or chest pain, nausea, vomiting or diarrhea, fatigue, fever, or weight loss, all symptoms presenting in patients with EVALI.ConclusionThis study provides insights into understanding the chemical-induced disease mechanism of acute lung injury.

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Vaping-related Lung Injury in an Adolescent

Cited by 11 publications

References 2 publications

Chemical Constituents Involved in E-Cigarette, or Vaping Product Use-Associated Lung Injury (EVALI)

Chemical Constituents Involved in E-Cigarette, or Vaping Product Use-Associated Lung Injury (EVALI)

A Systematic Literature Review of E-Cigarette-Related Illness and Injury: Not Just for the Respirologist

Chemical constituents involved in e-cigarette, or vaping product use-associated lung injury (EVALI)

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