Clinical and radiological manifestations of lipoid pneumonia according to etiology: Squalene, omega‐3‐acid ethyl esters, and idiopathic

Objectives Clinical manifestations of lipoid pneumonia (LP) vary depending on the causative agents or underlying causes. The aim of the present study was to investigate the clinical and radiological features of LP, classified according to etiologic agents. Methods The clinico‐radiological characteri...

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Published in:The clinical respiratory journal 2019-05, Vol.13 (5), p.328-337
Main Authors: Cha, Seung‐Ick, Choi, Sun Ha, Kim, Hyun Jung, Kim, Yeon Jae, Lim, Jae‐Kwang, Yoo, Seung‐Soo, Lee, Shin‐Yup, Lee, Jaehee, Kim, Chang‐Ho, Park, Jae‐Yong
Format: Article
Language:English
Subjects:
Aged
Bronchoalveolar Lavage
bronchoalveolar lavage fluid
computed tomography
Esters
Fatty Acids, Omega-3 - adverse effects
Humans
lipid pneumonia
Middle Aged
Neutrophils
Pneumonia
Pneumonia, Lipid - diagnostic imaging
Pneumonia, Lipid - etiology
Recurrence
Republic of Korea
Retrospective Studies
squalene
Squalene - adverse effects
Tomography, X-Ray Computed
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Summary:Objectives Clinical manifestations of lipoid pneumonia (LP) vary depending on the causative agents or underlying causes. The aim of the present study was to investigate the clinical and radiological features of LP, classified according to etiologic agents. Methods The clinico‐radiological characteristics of LP patients were retrospectively compared among groups: exogenous versus idiopathic and squalene versus omega‐3‐acid ethyl esters (O‐3‐AEE) versus idiopathic. Idiopathic group was defined as LP with no proven or reported etiological evidence. Results Twenty‐two patients met the diagnostic criteria for LP: squalene (9 [41%]), O‐3‐AEE (6 [27%]), olive oil (1 [5%]), and idiopathic (7 [32%]). Compared with the exogenous group, the idiopathic group showed a higher recurrence rate; higher frequencies of bronchial anthracofibrosis (BAF) and bronchoalveolar lavage (BAL) lymphocytosis; and a higher rate of crazy‐paving pattern and lower rate of consolidation on computed tomography scan. In three‐group tests, compared with the O‐3‐AEE group, the squalene group exhibited a significantly higher percentage of neutrophils and a higher rate of right middle lobe (RML) involvement. Conclusions In comparison with the exogenous group, the idiopathic group demonstrated BAL lymphocytosis, higher rates of recurrence and BAF, and a higher rate of crazy‐paving pattern. Compared with the O‐3‐AEE group, the squlaene group showed a higher percentage of BAL neutrophils and predominant RML involvement.
ISSN:1752-6981
1752-699X
DOI:10.1111/crj.13015