Respiratory failure caused by lipoid pneumonia from vaping e-cigarettes

BMJ Case Rep. 2018 Jul 6;2018:bcr2018224350. doi: 10.1136/bcr-2018-224350.


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.

Keywords: interstitial lung disease; pneumonia (respiratory medicine).

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Inflammatory Agents
  • Bronchoalveolar Lavage
  • Electronic Nicotine Delivery Systems*
  • Female
  • Flavoring Agents / adverse effects
  • Glycerol / adverse effects
  • Humans
  • Lung / diagnostic imaging*
  • Lung / pathology
  • Pneumonia, Lipid / complications*
  • Pneumonia, Lipid / diagnostic imaging
  • Pneumonia, Lipid / drug therapy
  • Prednisolone / administration & dosage
  • Propylene Glycols / adverse effects
  • Respiratory Insufficiency / drug therapy
  • Respiratory Insufficiency / etiology*
  • Tomography, X-Ray Computed
  • Vaping / adverse effects*


  • Anti-Inflammatory Agents
  • Flavoring Agents
  • Propylene Glycols
  • Prednisolone
  • Glycerol