DOI QR코드

DOI QR Code

Electronic Cigarette or Vaping-Associated Lung Injury Manifested as Acute Eosinophilic Pneumonia: A Case Report

급성호산구성폐렴으로 발현된 전자담배 관련 폐 손상: 증례 보고

  • Thomas J Kwack (Department of Radiology, Ansan Hospital, Korea University) ;
  • Cherry Kim (Department of Radiology, Ansan Hospital, Korea University) ;
  • Sung Ho Hwang (Department of Radiology, Anam Hospital, Korea University) ;
  • Hwan Seok Yong (Department of Radiology, Guro Hospital, Korea University) ;
  • Yu‑Whan Oh (Department of Radiology, Anam Hospital, Korea University) ;
  • Eun‑Young Kang (Department of Radiology, Guro Hospital, Korea University)
  • 곽정훈 (고려대학교 안산병원 영상의학과) ;
  • 김채리 (고려대학교 안산병원 영상의학과) ;
  • 황성호 (고려대학교 안암병원 영상의학과) ;
  • 용환석 (고려대학교 구로병원 영상의학과) ;
  • 오유환 (고려대학교 안암병원 영상의학과) ;
  • 강은영 (고려대학교 구로병원 영상의학과)
  • Received : 2022.01.03
  • Accepted : 2022.06.18
  • Published : 2023.01.01

Abstract

Electronic cigarette or vaping-associated lung injury (EVALI) is a disease defined by lung injuries caused by e-cigarette use. It predominantly manifests in forms of organized pneumonia or diffuse alveolar damage but rarely as acute eosinophilic pneumonia (AEP). This report describes a 34-year-old male with acute respiratory symptoms and a vaping history of only nicotine. Chest CT revealed peripheral distributing multiple patchy consolidations and ground-glass opacities dominant in both lower lobes, bilateral diffuse interlobular septal thickening, and bilateral pleural effusion without cardiomegaly. Bronchoalveolar lavage fluids showed increased eosinophilia levels, while infectious laboratory results were all negative, enabling the diagnosis of both AEP and EVALI. Herein, we report a rare case of only-nicotine vaping EVALI manifested as AEP.

전자담배 관련 폐 손상(electronic cigarette or vaping-associated lung injury)은 전자담배에 의해 발생하는 폐 손상으로, 주된 병리 소견은 기질화폐렴 혹은 미만성폐포손상이며 드물게 급성호산구폐렴을 보인다. 본 증례에서 대마 추출물이 없는 니코틴 액상 전자담배 흡연력의 34세 남자 환자가 급성 호흡기 증상, 흉부 CT에서 양측 폐하엽의 주변부의 다발성 경화와 간유리음영, 미만성의 소엽간격막 비후, 흉막삼출을 보였다. 기관지폐포세척액에서는 호산구증이 있었고 감염성 검사들은 모두 음성으로 보였기에 진단기준에 부합하는 급성호산구 폐렴으로 발현한 대마 추출물이 없는 니코틴 액상 전자담배 관련 폐 손상의 희귀한 증례를 보고한다.

Keywords

References

  1. Lim J, Nam BD, Hwang JH, Kim YK, Oh E, Lee EJ. Electronic cigarette or vaping product use-associated lung injury: a case report. J Korean Soc Radiol 2021;82:1581-1588
  2. Moritz ED, Zapata LB, Lekiachvili A, Glidden E, Annor FB, Werner AK, et al. Update: characteristics of patients in a national outbreak of e-cigarette, or vaping, product use-associated lung injuries-United States, October 2019. MMWR Morb Mortal Wkly Rep 2019;68:985-989
  3. Kligerman SJ, Kay FU, Raptis CA, Henry TS, Sechrist JW, Walker CM, et al. CT findings and patterns of e-cigarette or vaping product use-associated lung injury: a multicenter cohort of 160 cases. Chest 2021;160:1492-1511
  4. Layden JE, Ghinai I, Pray I, Kimball A, Layer M, Tenforde MW, et al. Pulmonary illness related to e-cigarette use in Illinois and Wisconsin-final report. N Engl J Med 2020;382:903-916
  5. Schier JG, Meiman JG, Layden J, Mikosz CA, VanFrank B, King BA, et al. Severe pulmonary disease associated with electronic-cigarette-product use-interim guidance. MMWR Morb Mortal Wkly Rep 2019;68:787-790
  6. Shorr AF, Scoville SL, Cersovsky SB, Shanks GD, Ockenhouse CF, Smoak BL, et al. Acute eosinophilic pneumonia among US military personnel deployed in or near Iraq. JAMA 2004;292:2997-3005
  7. Uchiyama H, Suda T, Nakamura Y, Shirai M, Gemma H, Shirai T, et al. Alterations in smoking habits are associated with acute eosinophilic pneumonia. Chest 2008;133:1174-1180
  8. Blount BC, Karwowski MP, Shields PG, Morel-Espinosa M, Valentin-Blasini L, Gardner M, et al. Vitamin E acetate in bronchoalveolar-lavage fluid associated with EVALI. N Engl J Med 2020;382:697-705
  9. Artunduaga M, Rao D, Friedman J, Kwon JK, Pfeifer CM, Dettori A, et al. Pediatric chest radiographic and CT findings of electronic cigarette or vaping product use-associated lung injury (EVALI). Radiology 2020;295:430-438
  10. Panse PM, Feller FF, Butt YM, Smith ML, Larsen BT, Tazelaar HD, et al. Radiologic and pathologic correlation in EVALI. AJR Am J Roentgenol 2020;215:1057-1064