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How vaping can cause a form of pneumonia

By University Of Utah Health | Posted - Aug 20th, 2019 @ 3:00pm



Aubree Butterfield liked vaping. She enjoyed the taste, it gave her something to do with her hands, and it was something all of her friends were doing as well. Also, she didn’t think it was harmful to her health like traditional cigarettes.

“We were told that it was harmless,” said Butterfield. “That it was fine to vape, way better than smoking cigarettes.”

Butterfield had been vaping on and off for about four years when she began experiencing chest pain and shortness of breath. At first, she assumed she had a cold or the flu. She didn’t think it could be related to vaping.

When she finally went to the hospital she told the doctor she didn’t smoke. In her mind she didn’t — she did the safer alternative of vaping. “My mom actually mentioned that I vaped before I did,” she said. “I didn't even think of it.”

Butterfield was diagnosed with lipoid pneumonia, a potentially deadly condition now being linked to vaping. Vaping cartridges contain oil that is heated with a heating element, which produces a vapor.

“Within that vapor, there may be tiny aerosolized droplets of lipids, which can be inhaled,” said Dr. Andrew Freeman, M.D., a pulmonologist with the University of Utah Health. “When large enough amounts of lipid droplets are inhaled into the lungs, they can cause irritation and damage to the lung, leading to the condition termed lipoid pneumonia.”


When large enough amounts of lipid droplets are inhaled into the lungs, they can cause irritation and damage to the lung, leading to the condition termed lipoid pneumonia.

Previously, lipoid pneumonia was primarily associated with the use of oil-based laxatives and accidental aspiration. That’s changing, though, as more people take up vaping, voluntarily introducing lipid particles into their lungs. Of course, that doesn’t mean that everyone who vapes will develop lipoid pneumonia. But they are putting themselves at risk.

“Though it has not been studied well, I suspect if you were to do a bronchoscopy on someone who vapes regularly, we may detect low levels of lipid particles in their lungs, even when they haven’t had enough to cause an injury,” Freeman said. “Thus, lipid droplets may not be causing irritation or injury to the lungs in all cases, but they are probably there. And the higher burden of lipid, the overall greater chance of developing lipoid pneumonia.”

Symptoms of lipoid pneumonia — chest pain, difficulty breathing, chronic coughing, or even coughing up blood — can be similar to some symptoms of bacterial pneumonia. The two conditions are treated differently, though.

With bacterial pneumonia, antibiotics can be given to treat the root cause. “With lipoid pneumonia, we don’t have a treatment that can dissolve or dissipate the lipids,” Freeman said. “Instead, we may try to decrease the inflammation with steroids, but much of the treatment is centered around supporting someone’s body while the respiratory system and lungs recover to the best of their natural ability on their own.”

Treatments for lipoid pneumonia include steroids, and, in some cases, attempts at lavaging or washing the lung with large volumes of saline. But no treatment has proven efficacy. In serious cases, where an advanced lung injury occurs, the patient may have to be put on high oxygen support or possibly even require respiratory support with a ventilator. In those scenarios, the condition is life-threatening.

Lipoid pneumonia can be fatal, but with the proper medical support and treatment, recovery is also possible. Any time there is a substantial acute injury to the lungs, however, patients may have a permanent decreased lung capacity, even after they have recovered.

“You need to take care of your lungs,” Freeman said. “Preventing damage to them is always the best idea. E-cigarettes and vaping have been associated with lipoid pneumonia as well as other severe lung injuries, including hypersensitivity pneumonitis and acute respiratory distress syndrome (ARDS). The inhaled vapors also include carcinogens such as nitrosamines, formaldehyde, and metals like nickel, chromium, and lead.”

Butterfield is now slowly recovering and says her vaping days are behind her. She has inspired several of her friends to kick the habit as well. “I wouldn't want to go through this again, and I don't want anyone else to go through this,” she said. “I wish vaping wasn't a thing.”

It’s best to put the vape pen down.

University Of Utah Health

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