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

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

doi:10.1155/2020/7151834

Cited by 17 publications

(17 citation statements)

References 14 publications

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“…In our case, the Oil Red O stain, which stains the lipid droplets in macrophages/ histiocytes, was strongly positive in the sections from the patient's lungs. This is supporting evidence of vaping, but it is not specific [9][10][11]. However, acute inhalational injury was documented by video bronchoscopy, and this provided confirmatory evidence of the vaping-induced lung injury [3-7, 12, 13].…”

Section: Discussionmentioning

confidence: 80%

Deadly combination of Vaping-lnduced lung injury and Influenza: case report

Akkanti¹,

Hussain²,

Patel³

et al. 2020

Diagn Pathol

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Background: E-cigarette and vaping use-associated acute lung injury (EVALI) has been recently recognized as a complication in individuals who use vaping devices. Another consideration is that EVALI may have an adverse influence on the outcome of intercurrent respiratory infections. We document this deadly combination in the case of a young man who had EVALI and simultaneous Influenza-A infection leading to severe Acute Respiratory Distress Syndrome (ARDS). Case presentation: A 27-year-old male with a history of tobacco and vaping use was admitted to hospital after two weeks of flu-like symptoms, diarrhea and vomiting. A chest x-ray was consistent with multifocal pneumonia, and microbiological tests were positive for Influenza-A and methicillin-sensitive Staphalacoccus aureus (MSSA). Bronchoscopy provided evidence of acute inhalational injury. After admission, he acutely decompensated with severe hypoxia and hypotension; he required intubation, sedation and vasopressors. He developed sepsis with acute kidney failure, liver failure, biventricular systolic dysfunction and severe rhabdomyolysis. He was placed on veno-venous (VV) extracorporeal membrane oxygenation (ECMO) initially and later changed to Veno-Arterial (VA) ECMO. Nevertheless, the patient continued to deteriorate, and he expired two weeks after admission. Conclusion: This case documents that EVALI can act as a major factor leading a respiratory infection to progress into severe ARDS with a fatal outcome.

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Section: Discussionmentioning

confidence: 80%

Deadly combination of Vaping-lnduced lung injury and Influenza: case report

Akkanti¹,

Hussain²,

Patel³

et al. 2020

Diagn Pathol

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“…Gay et al 39 46/M Case of ELP due to use of cannabis-containing e-cigarettes. CT, X-ray, and lung biopsy showed many abnormalities.…”

Section: Overview Of Potential Causes Of Evali Andmentioning

confidence: 99%

Chemistry Review of Vaping Products and Respiratory Injury

2020

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Background: While the Public Health Agency of Canada notes 19 cases from May 2019 to February 2020 relating to e-cigarette or vaping product use-associated lung injury (EVALI) in Canada, there are likely many more unreported cases, including non-hospitalized and asymptomatic cases. E-cigarette use or vaping exposes users to numerous aerosolized chemical species, some of which have proven to be deleterious to health. These chemical species can include vitamin E acetate (VEA), flavourants, base / solvents (propylene glycol or vegetable glycerin), psychoactive substances, pesticides, endotoxins, metals, and pyrolysis by-products from e-cigarette heating coils. Objectives: We aim to review current findings related to EVALI from the standpoint of known chemical species currently used in vaping products. We specifically examine the toxicological profiles of these chemical species and the mechanisms through which they cause lung injury. Methods: A comprehensive literature search was performed with MEDLINE for EVALI-related human studies that were published between January 1, 2010, and May 15, 2020. This search strategy identified 832 case reports, case series, clinical trials, and in-vitro laboratory studies. From this group, 71 records were examined in greater detail. Results and Conclusions: Although the chemical composition and toxicology of vaping products have largely been characterized, the physiological effects of the chemical interactions between various constituents of vaping products and the generation of new species remain inconclusive. Given the rapid increase in the popularity of vaping and e-cigarettes, there is a need for further research. Developing a comprehensive understanding of the chronic health effects of vaping through randomized controlled trials and physiological studies is prudent and necessary to reduce the long-term impacts on users and the health care system.

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“…Análise anatomopatológica foi realizada em 164 desses indivíduos, (material via broncoscopia) e achados mais frequentes: dano alveolar difuso, hemorragia 8 alveolar; pneumonia lipoide, proteinose alveolar e BOOP em alguns casos. 2,4,5,6,18,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49…”

Section: Fonte: Dados Coletados Pelos Autoresunclassified

Lesões Pulmonares Associadas ao Uso do Cigarro Eletrônico

D’Almeida¹,

Silveira²,

Poiano³

et al. 2020

Blucher Medical Proceedings

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Vaping Associated Lung Injuries/Illnessess (lesões pulmonares/doenças pulmonares associadas ao cigarro eletrônico ou ao "vaping").Difundido pela indústria do tabaco como menos prejudicial à saúde, o cigarro eletrônico ganhou espaço entre jovens. Mas seu uso vem causando síndrome emergente, com manifestações clínicas importantes e até mesmo óbito. O diagnóstico é de exclusão. O tratamento é feito com cessação do uso do cigarro eletrônico e terapia empírica com corticóides, antimicrobianos e antivirais. OBJETIVO: Descrever as principais manifestações clínicas, radiológicas e anátomo patológicas em pacientes com EVALI. METODOLOGIA: Revisão narrativa sistematizada, em base de dados: Bireme, Cochrane Library, Pubmed e Scielo. Descritor utilizado: "Electronic Nicotine Delivery Systems" AND "Lung Injury". Selecionados publicações dos últimos dez anos (línguas inglesa, espanhola e portuguesa), sem restrição do tipo de estudo. 402 artigos incialmente; excluídos os repetidos em diferentes bases de dados e os que não se relacionavam ao tema ou se relacionavam com outras doenças. Por fim, 101 estudos foram utilizados. RESULTADOS: 2.668 relatos de pessoas com EVALI (até 14 janeiro 2020), média de idade 24 anos (13 a 85 anos); 66 % sexo masculino; Tempo médio de uso do cigarro eletrônico de 12,8 meses (variando de 1 dia a 5 anos de uso).Manifestações clínicas: dispneia (66,5%), tosse (64%), febre (60%), fadiga (40%) e dor torácica (35,5%). Sintomas gastrointestinais foram frequentes: vômitos (48%), náuseas (45%), diarréia (25%) e dor abdominal (19%). Cerca 25% dos pacientes apresentaram taquipneia e hipoxemia e 3,6% hemoptise. Manifestações radiológicas: infiltrado intersticial (vidro fosco) em mais de 90% dos casos e raramente consolidações, opacidades alveolares, lesões cavitárias e bronquiectasias. Análise anatomopatológica realizada em 164 desses indivíduos, (material via broncoscopia) e achados mais frequentes: dano alveolar difuso, hemorragia alveolar; pneumonia lipoide, proteinose alveolar e BOOP em alguns casos. E 68 casos evoluíram a óbito. CONCLUSÃO:O uso do cigarro eletrônico é uma nova forma de tabagismo

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

Cited by 17 publications

References 14 publications

Deadly combination of Vaping-lnduced lung injury and Influenza: case report

Deadly combination of Vaping-lnduced lung injury and Influenza: case report

Chemistry Review of Vaping Products and Respiratory Injury

Lesões Pulmonares Associadas ao Uso do Cigarro Eletrônico

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