Lipoid pneumonia from e-cigs is turning up in England, too

Our colleagues in England who remain wedded to e-cigs have been saying that the cases of lipoid pneumonia are an American phenomena.  They missed this case report -- Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes – published by BMJ showing the same problems are happening there as in America (and other countries).

Here is the abstract:

A young female vaper presented with insidious onset cough, progressive dyspnoea on exertion, fever, night sweats and was in respiratory failure when admitted to hospital. Clinical examination was unremarkable. Haematological tests revealed only thrombocytopenia, which was long standing, and her biochemical and inflammatory markers were normal. Chest radiograph and high-resolution CT showed diffuse ground-glass infiltrates with reticulation. She was initially treated with empirical steroids and there was improvement in her oxygenation, which facilitated further tests. Since the bronchoscopy and high-volume lavage was unyielding, a video-assisted thoracoscopicsurgical biopsy was done later and was suggestive of lipoid pneumonia. The only source of lipid was the vegetable glycerine found in e-cigarette (EC). Despite our advice to quit vaping, she continued to use EC with different flavours and there is not much improvement in her clinical and spirometric parameters.

The full citation is Viswam D, Trotter S, Burge PS, Walters GI.  Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes. BMJ Case Rep. 2018 Jul 6;2018. pii: bcr-2018-224350. doi: 10.1136/bcr-2018-224350.  The paper is available here.