Pneumonia lipoide secundária ao uso prolongado de óleo de prímula

Abstract

A 50-year-old never-smoking female, born and raised in the city of Goiânia, Brazil, presented with a two-year history of productive cough. She had no other complaints. The only finding during the physical examination was scattered fine rales on pulmonary auscultation.After the initial investigation, the patient was diagnosed with bronchial hyperresponsiveness associated with gastroesophageal reflux IntroductionMicroaspiration of lipid substances can lead to lipoid pneumonia.(1) The reported cases have been associated with the therapeutic use of mineral oil as a laxative by individuals with chronic constipation. However, other forms of treatment with lipid preparations might be implicated. We report the case of a female patient with chronic exogenous lipoid pneumonia secondary to the use of evening primrose oil. AbstractLipoid pneumonia is an underdiagnosed disease that is caused by the aspiration of lipid particles into the lungs. Although most of the reported cases have been associated with the use of mineral oil as a laxative, other lipid substances can also cause the disease. We report the case of a 50-year-old female patient with a complaint of productive cough who was initially diagnosed with bronchial hyperresponsiveness and gastroesophageal reflux disease (GERD). The patient was treated for GERD. Because the productive cough persisted, the patient underwent chest CT, fiberoptic bronchoscopy, and open lung biopsy. She was diagnosed with lipoid pneumonia. The patient was questioned regarding the use of lipid substances, and she reported the chronic use of evening primrose oil. After the discontinuation of the substance and the maintenance of GERD treatment, her condition improved.

The effect of therapeutic bronchoalveolar lavage in combination with glucocorticoids on children with acute exogenous lipoid pneumonia

“…Regardless of location, the inflammatory response can destroy the alveolar walls and the interstitium, and the resultant fibrosis can occasionally progress to end‐stage lung disease. 18 , 20 , 27 , 28 In this study, we divided all patients into two groups based on the source of aspirated substances; the clinical‐radiological features were found no statistical difference in both group.…”

Exogenous Lipoid Pneumonia Complicated by Mineral Oil Aspiration in a Patient With Chronic Constipation: A Case Report and Review

“…Predisposing conditions that increase the risk of ELP include extremes of age, anatomical and functional abnormalities of pharynx/esophagus, and neuromuscular disorders [6][7][8][9]. However, 25% of ELP cases have been reported in healthy individuals without any underlying conditions [2].…”

A case report of exogenous lipoid pneumonia associated with avocado/soybean unsaponifiables

“…The risk of ELP is increased in multiple esophageal disorders and GERD [1, 4, 10]. Hiatal hernia has been associated with ELP in 2 cases reported in the literature [11, 12].…”

“…Diagnosing ELP is based on a history of exposure to exogenous fat, compatible radiological findings, and a demonstration of lipids in lung biopsy specimens or BAL [1, 6, 10, 13, 14]. In a French case series, GERD was associated with ELP in 50% of cases [1].…”