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Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes
  1. Darsana Viswam1,
  2. Simon Trotter2,
  3. P Sherwood Burge1,
  4. Gareth I Walters1
  1. 1Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK
  2. 2Department of Pathology, Birmingham Heartlands Hospital, Birmingham, UK
  1. Correspondence to Dr Darsana Viswam, darsana.viswam{at}


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.

  • pneumonia (respiratory medicine)
  • interstitial lung disease

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  • Contributors GW is the responsible consultant for the patient and was involved in the management of the patient all throughout and also provided guidance in preparing the article and also revising and editing the article as per BMJ format. ST and SB are members of the ILD (Interstitial Lung Disease) board and contributed significantly in crucial decision-making to reach a diagnosis. ST is a lung histopathologist who confirmed the diagnosis after considering the history of exposure. All the authors have read the article and suggested necessary amendments.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.