Aberegg SK, et al. Clinical, Bronchoscopic, and Imaging Findings of e-Cigarette, or Vaping, Product Use–Associated Lung Injury (EVALI) Among Patients Treated at an Academic Medical Center. JAMA Netw Open. 6 Nov 2020;3(11):e2019176. doi:10.1001/jamanetworkopen.2020.19176https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2772564
This case series of 31 adult patients diagnosed with EVALI between June 24 and December 10, 2019, took place at an academic medical center in Salt Lake City, Utah. It was reported to characterize clinical features, bronchoscopic findings, imaging patterns, and outcomes of EVALI. Patients were primarily men (24 [77%]) and White individuals (27 [87%]) who used e-cigarette products containing tetrahydrocannabinol (THC) (29 [94%]).
“In this case series, patients with EVALI characteristically presented with a flu-like illness with elevated inflammatory markers, lipid-laden macrophages (LLMs) on bronchoalveolar lavage (BAL) samples, and an organizing pneumonia pattern on CT imaging. Bronchoscopic testing for infection had a high incidence of false-positive results. Patients had substantial residual abnormal results at early follow-up. These data suggest a limited role for bronchoscopy in typical presentations of EVALI without risk factors for alternative diagnoses and the need for careful longitudinal follow-up.”
A useful commentary on this case series makes important points regarding EVALI tests, treatment, and follow-up; Koslow M, Petrache I.
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2772562
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Stephen Hamann
