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Years ago, this doctor associated mysterious lung disease with vaping



p. John E. Parker was working at a hospital in West Virginia in 2015 when a 31-year-old patient was admitted with acute respiratory problems. A team of doctors eventually suspected her mysterious case of lipoid pneumonia may be related to vaping, and we were not sure they had seen anything like this before. They were intrigued enough to provide a case report – a type of medical paper for unusual or provocative findings from patients. Such reports can serve as a call to the medical community to be on the alert, although they sometimes raise more questions than answer.

This summer, almost four years later, federal officials have launched an investigation into a national vaping center for severe pulmonary disease that has affected more than 1

50 patients in 16 countries. In an interview with Parker, a professor of pulmonary critical care and sleep medicine at West Virginia University, he described what happened.

Question: Can you describe the patient's symptoms upon arrival?

We will look at these are classic for what is called vaping related lung disease. She was very, very breathless and coughing and we, of course, were very worried that there might be pneumonia or some other acute respiratory illness. And then she was so sick that she had to be intubated.

Q: What happens next in such cases?

We are looking for things like [hemorrhage] or active infection. And then for macrophages containing lipids. And then we usually start some antibiotics [and a] low-dose steroids and then support the patient with ventilator and oxygen and nutrition. And then just wait and see if any other culture comes back to prove something different than what you might think.

At first, we just felt that it was an unusual case and may not be a common viral or bacterial infection.

Q: How did you find out the cause of her lipoid pneumonia was electronic cigarettes?

This is an exclusion diagnosis. We excluded others [options] and this became the most probable cause.

We were convinced enough that the case was presented in the same year at the American College of Breast Physicians' annual meeting.


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