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Lipoid Pneumonia: Causes, Symptoms, Treatment

What is Lipoid Pneumonia?

Lipoid Pneumonia which is also known by the name of Lipid Pneumonia is a rare pulmonary condition characterized by presence of lipid or fat in the lungs, specifically alveoli. Lipoid Pneumonia is categorized into two namely exogenous and endogenous. If the lipid or fat is present in the lungs from an external source then it is termed as exogenous Lipoid Pneumonia and if the fat enters the lungs through an internal source or the source is not known or idiopathic then it is termed as endogenous Lipoid Pneumonia.[1,2,3]

In most cases, Lipoid Pneumonia is caused due to external source mainly due to aspiration due to problems with swallowing or coughing while eating. In children, Lipoid Pneumonia may occur due to palatal abnormalities while in adults and elderly population it may occur as a result of neurological or gastrointestinal abnormalities. The symptoms of Lipoid Pneumonia are quite similar to the common pneumonia which include cough, fever, and shortness of breath.[1,2,3]

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Lipoid Pneumonia can be quite tough to diagnose due to the similarity in the symptoms and diagnosis is mostly made after looking at radiographs. The best way to treat Lipoid Pneumonia is through rest and medications in most cases. However if the condition is severe then treatment is done in an inpatient setting. Corticosteroids are the most preferred way to treat Lipoid Pneumonia to decrease the inflammation in the lungs that is caused due to the fat accumulation. Antibiotics are not preferred in the treatment of Lipoid Pneumonia unless there is confirmed presence of bacterial infection.[1,2,3]

What Causes Lipoid Pneumonia?

Lipoid Pneumonia occurs when the immune system of the body reacts to the presence of fat within the alveoli in the lungs. Due to the immune system getting activated, the air sacs and the lungs become inflamed and fill up with fluid causing the symptoms that are seen with Lipoid Pneumonia. As stated above, there are two types of Lipoid Pneumonia, namely exogenous and endogenous. The causes of exogenous Lipoid Pneumonia include using e-cigarettes, inhaling oil based products, and oil pulling.[3]

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E-Cigarettes: The Center for Disease Control in 2019 had reported five cases wherein people had developed Lipoid Pneumonia after using e-cigarettes which contained marijuana oil. The oil went into the lungs and caused Lipoid Pneumonia.[3]

Oil-Based Products: Inhaling oil-based products is yet another cause for Lipoid Pneumonia. This is usually seen at place of work like in a chemical factory or people who use heavy machinery. Traces of oil from the machine may mix with the air and the person unknowingly may inhale it causing Lipoid Pneumonia. It is best to wear a mask in such circumstances.[3]

Oil Pulling: This is quite a common practice in people who are involved with alternative medicine. The person fills the mouth with oil and moves it around before spitting it out. This is believed to improve dental health although there is very little scientific evidence for it. A study done in 2015 had made a mention of two cases of Lipoid Pneumonia due to oil pulling as some amount of oil entered the lungs.[3]

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Other Causes: There has been a case reported of a female who developed Lipoid Pneumonia after applying baby oil to the inside of the nose for several years. There was another case reported where a person who inhaled liquid paraffin developed Lipoid Pneumonia.[3]

Endogenous Lipoid Pneumonia: This is quite less common than the other form of Lipoid Pneumonia. This develops when the fat from the body gets accumulated in the lungs. On radiographs, this fat may appear as a nodule. By analysis of this nodule, Lipoid Pneumonia can be easily diagnosed. The primary cause of this is believed to be blockage in the lungs causing inflammation resulting in the body producing excess cholesterol. This cholesterol then breaks down and accumulates in the lungs causing Lipoid Pneumonia.[3]

What are the Symptoms of Lipoid Pneumonia?

As stated, the symptoms of Lipoid Pneumonia are quite similar to the common pneumonia. It includes persistent cough, difficulty breathing, and high fever. Some people also complain of chest pain and shivering. If e-cigarettes are believed to be the cause of Lipoid Pneumonia then the individual may also have vomiting, nausea, and pain in the stomach.[3]

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Lipoid Pneumonia is a slowly progressive disease as and when fat accumulates in the lungs. Difficulty breathing is the first symptom that a person with Lipoid Pneumonia experiences.[3]

How is Lipoid Pneumonia Treated?

As is the case with common pneumonia, if a person has any other underlying medical health condition then Lipoid Pneumonia tends to be more severe and hospitalization may be required. Since Lipoid Pneumonia is extremely rare, there are no specific treatment protocols for this condition. Primary treatment is use of corticosteroids to decrease inflammation and suppress the immune system. In case if the individual develops a lung infection, then a course of antibiotics may have to be administered.[3]

Another treatment that has been quite beneficial for Lipoid Pneumonia is the whole lung lavage. This procedure involves manually removing fat from the lungs. This is done under general anesthesia and involves cleaning and rinsing the lungs with saline solution and allowing all the fat to come out. At one time only one lung is treated with this method and then a two week gap is given before proceeding with the other one.[3]

This period of two weeks gives the lungs time to heal which ultimately improves breathing of the patient. Additionally, rest is also quite important for people with Lipoid Pneumonia for complete recovery.[3]

What Is The Prognosis Of Lipoid Pneumonia?

Any form of pneumonia can be quite serious in people with premorbid conditions or older adults. If not dealt with on time, it may lead to a variety of complications including lung abscesses and pleurisy. Resting and taking medications as directed is the key for complete recovery from Lipoid Pneumonia. It generally takes about three to four weeks for a person to completely recover from pneumonia.[3]

In cases of Lipoid Pneumonia, there is very little data in the literature about the overall prognosis due to the rarity of the condition. However, whatever data that is available, in all those cases patients recovered completely after treatment in the hospital.[3]

In conclusion, Lipoid Pneumonia is a rare pulmonary condition in which fat enters the lungs specifically the alveoli. There are two types of Lipoid Pneumonia namely exogenous and endogenous. Exogenous Lipoid Pneumonia has an external source as to its cause while endogenous Lipoid Pneumonia has an internal cause. Majority of the cases of Lipoid Pneumonia are exogenous meaning the fat enters the lungs through an external source like e-cigarettes or oil pulling.[1,2,3]

The severity of the symptoms of Lipoid Pneumonia is variable and differs from individual to individual. However, people with underlying medical conditions tend to have severe symptoms and need treatment in an inpatient setting even though there is no specific protocol with regard to the treatment for Lipoid Pneumonia.[1,2,3]

Corticosteroids and plenty of rest is the main form of treatment for this condition. However, another method called as whole lung lavage in which fat is manually removed from the lungs under general anesthesia using normal saline has been shown to be quite effective. In majority of the cases, it takes about a month to completely recover from Lipoid Pneumonia.[1,2,3]

References:

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