Viswam Darsana, Trotter Simon, Burge P Sherwood, Walters Gareth I
Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK.
Department of Pathology, Birmingham Heartlands Hospital, Birmingham, UK.
BMJ Case Rep. 2018 Jul 6;2018:bcr-2018-224350. doi: 10.1136/bcr-2018-224350.
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.
一名年轻的女性电子烟使用者出现隐匿性咳嗽、进行性劳力性呼吸困难、发热、盗汗，入院时已处于呼吸衰竭状态。临床检查无明显异常。血液学检查仅显示长期存在的血小板减少，其生化和炎症指标正常。胸部X线片和高分辨率CT显示弥漫性磨玻璃影伴网状改变。她最初接受经验性类固醇治疗，氧合情况有所改善，这有助于进一步检查。由于支气管镜检查和大容量灌洗未取得结果，后来进行了电视辅助胸腔镜手术活检，提示为类脂性肺炎。唯一的脂质来源是电子烟（EC）中发现的植物甘油。尽管我们建议她戒烟，但她仍继续使用不同口味的电子烟，其临床和肺功能参数改善不大。
