The Drug-Induced Respiratory Disease Website
(Fr: PINS aiguë). Acute, generally bilateral and diffuse pneumonitis. More rapid in onset and/or denser, more extensive and severe than pattern Ib. Can be fulminate in the form of diffuse pulmonary interstitial or alveolar opacities and the ARDS picture (see under IIb). BAL is generally lymphocytic and is also indicated to rule out pneumonia due to Pneumocystis, BCG, viruses or other agents particularly in the immunodepressed. Pathology (lung biopsy is not necessary in the majority; before going for the biopsy, please look at PMID 25950989) may disclose dense NSIP, widespread granulomas, or OP depending both on patient and drug. In severe cases pulmonary edema, DAD and/or DAH may develop. Corticosteroid therapy is indicated if patients progress to acute respiratory failure, once an infection has been carefully and resonably ruled out. Transition to pulmonary fibrosis is very uncommon. The boundary between patterns Ia and Ib may be difficult to delineate. See also under IIb
Publications
Crazy vaping and crazy-paving, a case of E-Cigarette/Vaping-Associated Lung Injury (EVALI) with chest CT showing crazy-paving pattern.
Radiology case reports 2021 Nov;16;3208-3212 — 2021 Nov — 3208-3212
Vaping-induced lung injury in a 21-year-old woman.
BMJ case reports 2020 Nov 30;13; — 2020 Nov 30
Acute Respiratory Failure Associated With Vaping.
Chest 2020 Mar;157;e63-e68 — 2020 Mar — e63-e68
Heinzerling A, Armatas C, Karmarkar E, Attfield K, Guo W, Wang Y, Vrdoljak G, Moezzi B, Xu D, Wagner J, Fowles J, Dean C, Cummings KJ, Wilken JA
Severe Lung Injury Associated With Use of e-Cigarette, or Vaping, Products-California, 2019.
JAMA internal medicine 2020 Mar 06;; — 2020 Mar 06
Layden JE, Ghinai I, Pray I, Kimball A, Layer M, Tenforde M, Navon L, Hoots B, Salvatore PP, Elderbrook M, Haupt T, Kanne J, Patel MT, Saathoff-Huber L, King BA, Schier JG, Mikosz CA, Meiman J
Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Preliminary Report.
The New England journal of medicine 2019 Sep 06;; — 2019 Sep 06
Hypersensitivity Pneumonitis and Acute Respiratory Distress Syndrome From E-Cigarette Use.
Pediatrics 2018 06;141; — 2018 06