Occupational and Environmental Lung Diseases: Occupational and Environmental Lung Diseases |

A Case Report of Lipoid Pneumonia Caused by Fish Oils FREE TO VIEW

Keqiang Wang
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Peking University People's Hospital, Beijing, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A409. doi:10.1016/j.chest.2016.02.425
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SESSION TITLE: Occupational and Environmental Lung Diseases

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: lipoid pneumonia is uncommon in China, while some patients administrating some drugs containing spinacene suffered it. The diagnosis need more detailed interrogation and bronchoscopy lavage.

METHODS: A 68-year-old woman were admitted in our hospital with coughing, sputum and fever. The white blood cell counts were normal (9.13*109/L) while the percentage of neutrophils elevated (82.9%), but she didn’t get remission with the antimicrobial agents. The physical examination was normal, procalcitonin was <0.1ng/mL and procalcitoninprocalcitoninprocalcitoninerythrocyte sedimentation rate was 48mm/H, C-reactive protein was 67.7mg/L. She didn’t show hypoxemia but showed a lower C3 and C4. The computer tomography presented ground glass changes in multi segments and even Crazy-Pavingsign.

RESULTS: The bronchoscopy lavage were performed with a result of Macrophage 22.5%, neutrophile granulocyte 58%, lymphocyte 17.5%, eosinophile granulocyte 2%. The BALF presented layered with an flavescent layer on top. Electron microscope were used for detection and were found a lot of lipoid balls. A more detailed interrogation prompted that the administration of fish oils containing spinacece in supine position were the cause of disease. The patients were eventually diagnosed lipoid pneumonia.

CONCLUSIONS: The administration of fish oil may cause lipoid pneumonia, the diagnosis need the proof of oral drugs’ using and bronchoscopy lavage.

CLINICAL IMPLICATIONS: Lipoid pneumonia is uncommon, but knowing the characteristics and diagnosis may help to identify some diseases with ground glass changes in CT.

DISCLOSURE: The following authors have nothing to disclose: Keqiang Wang

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