Tuberc Respir Dis.  1996 Dec;43(6):965-975. 10.4046/trd.1996.43.6.965.

Clinical investigation of lipoid pneumonia in adults

• Hyun JG
• Rhee CH

• KMID: 2044761
• DOI: http://doi.org/10.4046/trd.1996.43.6.965

Abstract

Background
Exogenous lipoid pneumonia is caused by inhalation or aspiration of animal, vegetable or mineral oil. Most cases are ascribed to aspiration of oil in laxatives or nose drops Petroleum, another pure hydrocarbon used as a base in various medications, is occasionally involved. Especially animal oil produces severe tissue inflammatory reaction, but most patients present with only abnormal chest X-ray and no specific clinical symptoms or signs. Method: Seven patients, 3 males and 4 females, with exogenous lipoid pneumonia, who was hospitalized or referred to pulmonary division at Samsung Medical Center from December 1994 to July 1996, were included. They hadn a history of taking shark liver oil(so-called "squalene") for varying period of time. We reviewed clinical, radioloic and pathologic findings. Result: Patients took 7 to 30 capsules of "squalene" a day for at least one month to 5 years. Six cases had chronic disease such as diabetes, hypertension, or cerebrovascular accident. Respiratory symptoms of mild fever, cough and sputum were present in 3 cases and in 3 cases there was no clinical symptoms and signs but abnormal findings by chest X-ray. The major radiologic findings by simple chest X-ray and computed tomography consisted of consolidation, infiltration involving mainly right middle and both lower lobes, and ground-glass opacity. Five of six bronchoscopic examinations demonstrated both lipid droplets floating on the surface of bronchoalveolar lavage fluid and lipid-laden macrophages in bronchoalveolar lavage fluid or lung tissue. Follow-up chest X-ray showed improvement in 4 cases but no marked interval change in 3 cases after removal of exposure to "squalene".
Conclusion
Shark liver oil can induce lipoid pneumonia in adults. In case of high clinical suspicion, confirmation of "squalene" use by careful history taking is required and bronchoscopy is helpful in diagnosis.

Keyword

Lipoid pneumonia; Shark liver oil; Bronchoscopy

MeSH Terms

Adult*
Animals
Bronchoalveolar Lavage Fluid
Bronchoscopy
Capsules
Chronic Disease
Cough
Diagnosis
Female
Fever
Follow-Up Studies
Humans
Hypertension
Inhalation
Laxatives
Liver
Lung
Macrophages
Male
Mineral Oil
Nose
Petroleum
Pneumonia*
Sharks
Sputum
Stroke
Thorax
Vegetables
Capsules
Laxatives
Mineral Oil
Petroleum