Whole lung lavage in the setting of exogenous lipoid pneumonia
Introduction: Lipoid pneumonia results from lipid deposition in the lungs, arising either exogenously or endogenously. Exogenous lipoid pneumonia occurs from aspiration or use of oil-based products such as mineral oil or nasal topicals. Beyond removing the offending agent, treatment options in adult...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-01-01
|
| Series: | Respiratory Medicine Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007125001108 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849252110739177472 |
|---|---|
| author | Gaurav A. Jategaonkar John Fanous Ryan Dunn Karen Swanson Michael B. Gotway Jehad Azar Henry D. Tazelaar Ana C. Zamora Ann M. Rusk |
| author_facet | Gaurav A. Jategaonkar John Fanous Ryan Dunn Karen Swanson Michael B. Gotway Jehad Azar Henry D. Tazelaar Ana C. Zamora Ann M. Rusk |
| author_sort | Gaurav A. Jategaonkar |
| collection | DOAJ |
| description | Introduction: Lipoid pneumonia results from lipid deposition in the lungs, arising either exogenously or endogenously. Exogenous lipoid pneumonia occurs from aspiration or use of oil-based products such as mineral oil or nasal topicals. Beyond removing the offending agent, treatment options in adults are limited. Corticosteroids may provide relief, but refractory cases necessitate alternative therapies. Whole lung lavage has shown promise in select pediatric and adult cases. We report a case of steroid-refractory exogenous lipoid pneumonia successfully treated with whole lung lavage. Case presentation: A 56-year-old non-smoker with coronary artery disease and recurrent pneumonia presented with 3 months of fever, weight loss, night sweats, and dyspnea following COVID-19 infection the previous year. Imaging revealed multifocal ground-glass opacities and pleural effusions, with negative infectious workup. Despite corticosteroid treatment, symptoms recurred, leading to multiple Emergency Department visits. Biopsy via bronchoscopy confirmed exogenous lipoid pneumonia, attributed to chronic mineral oil use for constipation. Despite cessation of mineral oil and prolonged steroid courses, his condition worsened. Bronchoalveolar lavage revealed 59 % lipid-laden macrophages. A multidisciplinary team recommended whole lung lavage. The patient underwent the procedure on the left lung, was successfully extubated the following day, and discharged 4 days post-procedure. Discussion: Exogenous lipoid pneumonia is typically managed by stopping the offending agent and corticosteroids, but no standard treatment exists for steroid-refractory cases. Whole lung lavage offers a potential option for symptomatic and imaging improvement. This case underscores the emerging role of whole lung lavage in severe, steroid-resistant exogenous lipoid pneumonia. |
| format | Article |
| id | doaj-art-da1f29ef81eb418c9a733fcc3a01090b |
| institution | Kabale University |
| issn | 2213-0071 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj-art-da1f29ef81eb418c9a733fcc3a01090b2025-08-20T03:56:42ZengElsevierRespiratory Medicine Case Reports2213-00712025-01-015710227410.1016/j.rmcr.2025.102274Whole lung lavage in the setting of exogenous lipoid pneumoniaGaurav A. Jategaonkar0John Fanous1Ryan Dunn2Karen Swanson3Michael B. Gotway4Jehad Azar5Henry D. Tazelaar6Ana C. Zamora7Ann M. Rusk8Mayo Clinic Alix School of Medicine, United States; Corresponding author. Arizona Campus, IERB Building 5951 E Mayo Blvd, Phoenix, AZ, 85054, United States.Division of Pulmonary and Sleep Medicine, Mayo Clinic, Arizona, United StatesDepartment of Internal Medicine, Mayo Clinic, Arizona, United StatesDivision of Pulmonary and Sleep Medicine, Mayo Clinic, Arizona, United StatesDepartment of Radiology, Mayo Clinic, Arizona, United StatesDivision of Pulmonary and Sleep Medicine, Mayo Clinic, Arizona, United StatesDepartment of Laboratory Medicine and Pathology, Mayo Clinic, Arizona, United StatesDivision of Pulmonary and Sleep Medicine, Mayo Clinic, Arizona, United StatesDivision of Pulmonary and Sleep Medicine, Mayo Clinic, Arizona, United States; Department of Critical Care Medicine, Mayo Clinic, Arizona, United StatesIntroduction: Lipoid pneumonia results from lipid deposition in the lungs, arising either exogenously or endogenously. Exogenous lipoid pneumonia occurs from aspiration or use of oil-based products such as mineral oil or nasal topicals. Beyond removing the offending agent, treatment options in adults are limited. Corticosteroids may provide relief, but refractory cases necessitate alternative therapies. Whole lung lavage has shown promise in select pediatric and adult cases. We report a case of steroid-refractory exogenous lipoid pneumonia successfully treated with whole lung lavage. Case presentation: A 56-year-old non-smoker with coronary artery disease and recurrent pneumonia presented with 3 months of fever, weight loss, night sweats, and dyspnea following COVID-19 infection the previous year. Imaging revealed multifocal ground-glass opacities and pleural effusions, with negative infectious workup. Despite corticosteroid treatment, symptoms recurred, leading to multiple Emergency Department visits. Biopsy via bronchoscopy confirmed exogenous lipoid pneumonia, attributed to chronic mineral oil use for constipation. Despite cessation of mineral oil and prolonged steroid courses, his condition worsened. Bronchoalveolar lavage revealed 59 % lipid-laden macrophages. A multidisciplinary team recommended whole lung lavage. The patient underwent the procedure on the left lung, was successfully extubated the following day, and discharged 4 days post-procedure. Discussion: Exogenous lipoid pneumonia is typically managed by stopping the offending agent and corticosteroids, but no standard treatment exists for steroid-refractory cases. Whole lung lavage offers a potential option for symptomatic and imaging improvement. This case underscores the emerging role of whole lung lavage in severe, steroid-resistant exogenous lipoid pneumonia.http://www.sciencedirect.com/science/article/pii/S2213007125001108Lipoid pneumoniaExogenous lipoid pneumoniaWhole lung lavageTreatment exogenous lipoid pneumoniawhole lung lavage adultsSteroid resistant lipoid pneumonia |
| spellingShingle | Gaurav A. Jategaonkar John Fanous Ryan Dunn Karen Swanson Michael B. Gotway Jehad Azar Henry D. Tazelaar Ana C. Zamora Ann M. Rusk Whole lung lavage in the setting of exogenous lipoid pneumonia Respiratory Medicine Case Reports Lipoid pneumonia Exogenous lipoid pneumonia Whole lung lavage Treatment exogenous lipoid pneumonia whole lung lavage adults Steroid resistant lipoid pneumonia |
| title | Whole lung lavage in the setting of exogenous lipoid pneumonia |
| title_full | Whole lung lavage in the setting of exogenous lipoid pneumonia |
| title_fullStr | Whole lung lavage in the setting of exogenous lipoid pneumonia |
| title_full_unstemmed | Whole lung lavage in the setting of exogenous lipoid pneumonia |
| title_short | Whole lung lavage in the setting of exogenous lipoid pneumonia |
| title_sort | whole lung lavage in the setting of exogenous lipoid pneumonia |
| topic | Lipoid pneumonia Exogenous lipoid pneumonia Whole lung lavage Treatment exogenous lipoid pneumonia whole lung lavage adults Steroid resistant lipoid pneumonia |
| url | http://www.sciencedirect.com/science/article/pii/S2213007125001108 |
| work_keys_str_mv | AT gauravajategaonkar wholelunglavageinthesettingofexogenouslipoidpneumonia AT johnfanous wholelunglavageinthesettingofexogenouslipoidpneumonia AT ryandunn wholelunglavageinthesettingofexogenouslipoidpneumonia AT karenswanson wholelunglavageinthesettingofexogenouslipoidpneumonia AT michaelbgotway wholelunglavageinthesettingofexogenouslipoidpneumonia AT jehadazar wholelunglavageinthesettingofexogenouslipoidpneumonia AT henrydtazelaar wholelunglavageinthesettingofexogenouslipoidpneumonia AT anaczamora wholelunglavageinthesettingofexogenouslipoidpneumonia AT annmrusk wholelunglavageinthesettingofexogenouslipoidpneumonia |