Kulhawik Dorota, Walecki Jerzy
Department of Radiology, Mazovian Center for Treatment of Lung Diseases and Tuberculosis in Otwock, Otwock, Poland.
Department of Radiology and Diagnostic Imaging, Independent Public Clinical Hospital, Otwock, Poland.
Pol J Radiol. 2015 Feb 4;80:62-6. doi: 10.12659/PJR.892334. eCollection 2015.
Toxic lung injury may manifest itself in many different ways, ranging from respiratory tract irritation and pulmonary edema in severe cases to constrictive bronchiolitis, being a more distant consequence. It is most often the result of accidental exposure to harmful substances at work, at home, or a consequence of industrial disaster.
This article presents a case of toxic lung injury which occurred after inhalation of legal highs, the so-called "artificial hashish" and at first presented itself radiologically as interstitial pneumonia with pleural effusion and clinically as hypoxemic respiratory insufficiency. After treatment with high doses of steroids, it was histopathologically diagnosed as organizing pneumonia with lipid bodies.
Due to the lack of pathognomonic radiological images for toxic lung injury, information on possible etiology of irritants is very important. As novel psychoactive substances appeared in Europe, they should be considered as the cause of toxic lung injury.
中毒性肺损伤可能以多种不同方式表现出来,从呼吸道刺激到严重情况下的肺水肿,再到更远期的缩窄性细支气管炎。它最常见于工作场所、家中意外接触有害物质,或是工业灾难的后果。
本文介绍了一例吸入合法兴奋剂即所谓“人工大麻”后发生的中毒性肺损伤病例,最初在放射学上表现为伴有胸腔积液的间质性肺炎,临床上表现为低氧性呼吸功能不全。经大剂量类固醇治疗后,组织病理学诊断为伴有脂质体的机化性肺炎。
由于中毒性肺损伤缺乏特征性的放射学影像,关于刺激物可能病因的信息非常重要。随着新型精神活性物质在欧洲出现,应将它们视为中毒性肺损伤的病因。