Pulmonary Illness and E-Cigarettes: New Devices with New Diseases

We are seeing patients with similar clinical characteristics that shared the used of e-cigarettes. Even though we have been unable to identify one single responsible component or a set of them, clearly the use of e-cigarettes has brought new pathologies.

Enfermedad pulmonar y cigarrillos electrónicos: Nuevos dispositivos con nuevas enfermedades

E-cigarettes are electronic battery powered devices that heat a liquid forming an inhalable aerosol. Several pulmonary diseases related to e-cigarettes have been reported as isolated cases, but never a series with a significant number of patients.

This study defined cases as people reporting the use of e-cigarettes 90 days prior symptom onset presenting pulmonary infiltration on imaging not attributed to other conditions.


Read also: E-Cigarettes vs. Nicotine Therapy to Stop Smoking.


53 were registered, mostly men, mean age 19. Mostly presented with respiratory symptoms (98%), gastrointestinal symptoms (81%) and constitutional symptoms (100%). They all presented bilateral pulmonary infiltrates.

94% of patients required hospitalization and one third mechanical ventilation. One patient died in hospital.

84% of patients reported having used tetrahydrocannabinol products in their devices, though there is a wide range of products and devices in the market.



Read also: E-Cigarettes: No Definitive Evidence on Their Potential Cardiovascular Effect, but Some Suggest Caution


Surveillance in one US state showed visits for severe pulmonary illness doubled between 2018 and 2019.

Conclusions

All patients used e-cigarettes and presented similar clinical characteristics, symptoms and imaging, not attributable to other conditions. Further study is required to characterize their physiopathology and identify the definitive cause.

Original Title: Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin — Preliminary Report.

Reference: Jennifer E. Layden et al. N Engl J Med. 2019 Sep 6. [Epub ahead of print].


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