In the past few months, the rise of respiratory illness related to the use of nicotine, THC, or CBD vaporizers has been surging in the U.S.
As of right now, there have been 3 deaths and an estimated 450 illnesses across 33 of 50 of the states in the U.S. A team of investigators at the University of Utah have identified a marker for vaping-related illness and have developed a testing protocol based on their findings that have pointed to the illness as a potential type of lipoid pneumonia.
Published on September 6 in the New England Journal of Medicine, these findings represent the first definitive marker that can be used to correlate the respiratory illnesses that are sweeping America.
People are going to their doctors with symptoms of chest pain, dry cough, shortness of breath, often accompanied with body aches, fevers, night sweats, and even nausea, vomiting, and abdominal pain. The basic treatment is supportive care which includes oxygen, and some of the more severe cases result in steroids, admittance to ICU, and even life support in the worst of the cases.
The CT scans of the patients indicate a serious pneumonia (either viral or bacterial), but the tests for both kinds of pneumonia have come back negative in these patients, leaving doctors puzzled. In six out of six cases seen recently at a hospital in Salt Lake City, Utah, all patients had cells in their lungs which contained a specific type of cell that was filled with fat. These were all patients who shared a common history of vaping and were all negative for the type of pneumonia for which they appeared to have the symptoms.
The patients had a procedure in which fluid is purposefully introduced to the lungs and then removed for examination of the fluid and the cells it collected (a bronchoalveolar lavage). The scientists then stained the fluid and looked through a microscope and found very distinct cells called macrophages, which are immune system cells which clean up infection. These macrophages are commonly found, but the fact that they contained droplets of oily material (lipids) is not common at all.
These macrophages are called lipid-laden macrophages, and using this test, they have confirmed numerous cases of what they are now theoretically calling “lipoid pneumonia” and are linking directly with vaping use. Even though they have found the lipid-laden macrophages, the vaping symptoms and images still don’t exactly meet the criteria to be called lipoid pneumonia—lipoid pneumonia is usually seen in older patients and is associated with accidental exposure through inhaling oil-based laxatives. The x-ray presentation of lipoid pneumonia is also different than the type of images that they are seeing with vaping.
As of right now, more tests need to be created in order to diagnose the mysterious illness that is related to use of a vaporizer. It’s important to note that it’s not just affecting people using electronic cigarette or nicotine vaporizers but is being seen in cases of people vaporizing THC or CBD directly as well. These substances are usually carried in an oil suspension.
Until further notice, the CDC (Centers for Disease Control and Prevention) have issued an investigation which is asking the public to consider the current risks and not to use electronic cigarettes and vaporizers until further notice.
If you develop symptoms of chest pain, dry cough, difficulty breathing, shortness of breath, body aches, fever, etc. while you are using a vaporizer, the CDC urges you to seek out medical attention immediately.
- “Pulmonary Lipid-Laden Macrophages and Vaping.” N Engl J Med , vol. 381, 2019, pp. 1488–1489., doi:10.1056/NEJMc1912038.