Learning objectives
To become familiar with some of the commercially available vaping devices.
To gain an understanding of the basic mechanism of action of the vaping devices.
To recognize the radiographic findings of vaping-associated ling injury (VAPI) or e-cigarette or vaping product associated lung injury (EVALI).
Background
Vaping lung disease is a newly identified lung disease with high morbidity and mortality, only recently recognized in the United States with fifty-seven deaths now reported and over 2600 cases of lung injury now attributable to e-cigarette use in the USA (as of January 7,2020). Many of the cases involve the mixing of cannabis (THC) components with the e-cigarette vaping liquids.
The recognition of this entity is highly important, as the incidence of e-cigarette use has exponentially escalated in school-age children in the USA.
The...
Findings and procedure details
We present an initial review of the Mayo Clinic experience of the pulmonary imaging manifestations associated with e-cigarette use. These findings are recently recognized and can mimic those of hypersensitivity pneumonitis, ARDS, organizing pneumonia and fibrosing-interstitial lung disease, most notably NSIP.
Over 75 patients have presented to the Mayo Clinic with histories and/or radiographic patterns of disease that were suspicious for possible cases of EVALI. In review of the medical records (with approval of the Institutional review board), ten patients have been identified to date...
Conclusion
E-cigarette or vaping product associated lung injury (EVALI) is a newly recognized lung disease with high mobility and mortality. The incidence of e-cigarette use has exponentially escalated in school-age children in the USA and the incidence of EVALI soared in late 2019, with Vitamin E-acetate identified as a causative agent, used as a solvent primarily in THC-containing vaping products. Prompt recognition and intervention, often with high-dose steroids may reduce morbidity and mortality. Thus, awareness of the spectrum of radiographic findings and clinical presentation is essential.
Personal information and conflict of interest
P. J. Mergo; Jacksonville, FL/US - nothing to disclose C. Kiel; Gainesville/US - nothing to disclose K. Kiel; Gainesville/US - nothing to disclose J. Stowell; Jacksonville/US - nothing to disclose C. Rojas; Jacksonville/US - nothing to disclose R. Grage; Jacksonville/US - nothing to disclose S. Sonavane; Jacksonville/US - nothing to disclose
Additional contributions and additions to the author list include:
D. Abia Trujillo2,K. Cummings3, R. Kuzo4, 2Jacksonville/US, 3Scottsdale/US, 4Rochester/US
References
1: Salzman GA, Alqawasma M, Asad H. Vaping Associated Lung Injury (EVALI): An Explosive United States Epidemic. Mo Med. 2019 Nov-Dec;116(6):492-496. PubMed PMID: 31911735.
2: Thakrar PD, Boyd KP, Swanson CP, Wideburg E, Kumbhar SS. E-cigarette, or vaping, product use-associated lung injury in adolescents: a review of imaging features. Pediatr Radiol. 2020 Jan 2. [Epub
ahead of print] PubMed PMID: 31897566.
3: Mikosz CA, Danielson M, Anderson KN, Pollack LA, Currie DW, Njai R, Evans ME, Goodman AB, Twentyman E, Wiltz JL, Rose DA, Krishnasamy...