Tags

Type your tag names separated by a space and hit enter

Clinical and radiological characteristics of e-cigarette or vaping product use associated lung injury.
Emerg Radiol. 2020 May 28 [Online ahead of print]ER

Abstract

PURPOSE

E-cigarette or vaping product use associated lung injury (EVALI) has received national attention as an epidemic resulting in cases of significant morbidity and mortality. We aim to present the clinical and imaging findings in adolescents with pulmonary symptoms from suspected EVALI.

METHODS

Chest radiographs and CTs of adolescents (< 19 years) with acute pulmonary symptoms and history of vaping were reviewed by two radiologists in consensus. Clinical presentation and laboratory data were derived from the electronic medical records including pulmonary function tests (PFTs).

RESULTS

Eleven patients were identified (9 male, mean 16.6 years). The most common presentation was progressive, subacute respiratory distress with abdominal pain. All but one of the patients tested positive for tetrahydrocannabinol. Chest radiograph features were notable for interstitial pattern of opacities (91%) and basilar abnormalities (82%). CT features were notable for ground-glass opacities (89%), interstitial opacities (78%), and subpleural sparing (67%). Eight patients underwent PFTs. Six had diffusing capacity measurement, which demonstrated impaired diffusion in 3 (50%). All patients received supportive treatment with supplemental oxygen and corticosteroids.

CONCLUSION

Adolescents with suspected EVALI commonly present with subacute respiratory distress with abdominal pain. Imaging findings include ground-glass opacities, subpleural sparing, and basilar opacities, most consistent with organizing pneumonia or hypersensitivity pneumonitis. Recognition of the common imaging findings may have significant patient management implications, especially if the diagnosis is not suspected clinically. The lung function effects of vaping are consistent with mildly reduced airflow, which improves on follow-up testing, and reduced diffusion capacity, which, concerningly, does not improve.

Authors+Show Affiliations

Department of Pulmonology, Children's Hospital of Philadelphia, Philadelphia, PA, USA.Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, 3NW40, Philadelphia, PA, 19104, USA. University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, 3NW40, Philadelphia, PA, 19104, USA. University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, 3NW40, Philadelphia, PA, 19104, USA.Department of Pulmonology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA.Department of Pulmonology, Children's Hospital of Philadelphia, Philadelphia, PA, USA. rappj@email.chop.edu. Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, 3NW40, Philadelphia, PA, 19104, USA. rappj@email.chop.edu. University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA, USA. rappj@email.chop.edu.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32462343

Citation

Chidambaram, Ambika G., et al. "Clinical and Radiological Characteristics of E-cigarette or Vaping Product Use Associated Lung Injury." Emergency Radiology, 2020.
Chidambaram AG, Dennis RA, Biko DM, et al. Clinical and radiological characteristics of e-cigarette or vaping product use associated lung injury. Emerg Radiol. 2020.
Chidambaram, A. G., Dennis, R. A., Biko, D. M., Hook, M., Allen, J., & Rapp, J. B. (2020). Clinical and radiological characteristics of e-cigarette or vaping product use associated lung injury. Emergency Radiology. https://doi.org/10.1007/s10140-020-01796-z
Chidambaram AG, et al. Clinical and Radiological Characteristics of E-cigarette or Vaping Product Use Associated Lung Injury. Emerg Radiol. 2020 May 28; PubMed PMID: 32462343.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical and radiological characteristics of e-cigarette or vaping product use associated lung injury. AU - Chidambaram,Ambika G, AU - Dennis,Rebecca A, AU - Biko,David M, AU - Hook,Marcus, AU - Allen,Julian, AU - Rapp,Jordan B, Y1 - 2020/05/28/ PY - 2020/04/18/received PY - 2020/05/19/accepted PY - 2020/5/29/entrez KW - Adolescents KW - Chest KW - EVALI KW - PFTs JF - Emergency radiology JO - Emerg Radiol N2 - PURPOSE: E-cigarette or vaping product use associated lung injury (EVALI) has received national attention as an epidemic resulting in cases of significant morbidity and mortality. We aim to present the clinical and imaging findings in adolescents with pulmonary symptoms from suspected EVALI. METHODS: Chest radiographs and CTs of adolescents (< 19 years) with acute pulmonary symptoms and history of vaping were reviewed by two radiologists in consensus. Clinical presentation and laboratory data were derived from the electronic medical records including pulmonary function tests (PFTs). RESULTS: Eleven patients were identified (9 male, mean 16.6 years). The most common presentation was progressive, subacute respiratory distress with abdominal pain. All but one of the patients tested positive for tetrahydrocannabinol. Chest radiograph features were notable for interstitial pattern of opacities (91%) and basilar abnormalities (82%). CT features were notable for ground-glass opacities (89%), interstitial opacities (78%), and subpleural sparing (67%). Eight patients underwent PFTs. Six had diffusing capacity measurement, which demonstrated impaired diffusion in 3 (50%). All patients received supportive treatment with supplemental oxygen and corticosteroids. CONCLUSION: Adolescents with suspected EVALI commonly present with subacute respiratory distress with abdominal pain. Imaging findings include ground-glass opacities, subpleural sparing, and basilar opacities, most consistent with organizing pneumonia or hypersensitivity pneumonitis. Recognition of the common imaging findings may have significant patient management implications, especially if the diagnosis is not suspected clinically. The lung function effects of vaping are consistent with mildly reduced airflow, which improves on follow-up testing, and reduced diffusion capacity, which, concerningly, does not improve. SN - 1438-1435 UR - https://www.unboundmedicine.com/medline/citation/32462343/Clinical_and_radiological_characteristics_of_e-cigarette_or_vaping_product_use_associated_lung_injury L2 - https://dx.doi.org/10.1007/s10140-020-01796-z DB - PRIME DP - Unbound Medicine ER -
Try the Free App:
Prime PubMed app for iOS iPhone iPad
Prime PubMed app for Android
Prime PubMed is provided
free to individuals by:
Unbound Medicine.