PT - JOURNAL ARTICLE AU - Darsana Viswam AU - Simon Trotter AU - P Sherwood Burge AU - Gareth I Walters TI - Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes AID - 10.1136/bcr-2018-224350 DP - 2018 Jul 06 TA - BMJ Case Reports PG - bcr-2018-224350 VI - 2018 4099 - http://casereports.bmj.com/content/2018/bcr-2018-224350.short 4100 - http://casereports.bmj.com/content/2018/bcr-2018-224350.full AB - 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.