Vaping illness: a 53-case review of clinical characteristics

  • Layden JE & al.
  • N Engl J Med
  • 6 Sep 2019

  • International Clinical Digest
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Takeaway

  • Clinical characteristics of the first case series of a mysterious vaping-related illness are delineated in a New England Journal of Medicine report from Illinois and Wisconsin.

Why this matters

  • This case series finds no single product or substance linked to the illness, but greater physician reporting to the state health departments and CDC will help to pinpoint causation of this emerging syndrome.

Study design

  • Case series of 53 cases meeting a case definition of anyone reporting use of e-cigarette devices and related products in the 90 days before symptom onset who had pulmonary infiltrates on imaging (radiograph or CT) and whose illnesses were not attributed to other causes.
  • Funding: None disclosed.

Key results

  • 83% of cases were male; median age, 19 years.
  • Clinical characteristics: 
    • 98% presented with respiratory symptoms.
    • 81% had gastrointestinal symptoms.
    • 100% had constitutional symptoms. 
    • 94% were hospitalised; 32% underwent intubation and mechanical ventilation.
    • Systemic glucocorticoids were used in 92%.
    • 1 death was reported.
  • 80% of cases reported having used the e-cigarette to deliver tetrahydrocannabinol products, but a wide variety of products and devices were reported.

Limitations

  • Possible unrepresentativeness of case series.

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