As the number of reports of vaping-related lung injury continues to increase globally, it has emerged that the first case of the condition in the UK was reported as far back as July of last year.
At that time, a team from Birmingham Heartlands Hospital reports the case of a 34-year-old female vaper who presented with insidious onset cough, progressive dyspnoea on exertion, fever and night sweats and was in respiratory failure when admitted to hospital.
Clinical examination was unremarkable. Haematological tests revealed only thrombocytopaenia, which was long standing, and her biochemical and inflammatory markers were normal.
Chest radiograph and high-resolution computed tomography 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.
As bronchoscopy and high-volume lavage were unyielding, a video-assisted thoracoscopic surgical biopsy was performed and the results were suggestive of lipoid pneumonia. The only source of lipid was the vegetable glycerine found in e-cigarette.
Writing in BMJ Case Reports, the authors advised healthcare professionals to enquire about the use of e-cigarettes containing vegetable glycerine when taking an exposure history for interstitial lung disease.
They say lipoid pneumonia should be considered a diagnosis for presentations of interstitial lung disease in vapers and bronchoalveolar lavage may be helpful in determining the pathological diagnosis.