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Published in: BMC Pulmonary Medicine 1/2019

Open Access 01-12-2019 | Pulmonary-Function Tests | Case report

A case report of exogenous lipoid pneumonia associated with avocado/soybean unsaponifiables

Authors: Jacques BOUTROS, Marine MUZZONE, Jonathan BENZAQUEN, Michael LEVRAUT, Charles-Hugo MARQUETTE, Fanny ROCHER, Yann DIASCORN, Bernard PADOVANI, Véronique HOFMAN, Sylvie LEROY

Published in: BMC Pulmonary Medicine | Issue 1/2019

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Abstract

Background

Exogenous lipoid pneumonia is a rare disease resulting from intra-alveolar accumulation of lipids of mineral, vegetal, or animal origin, that induce a foreign body type of inflammatory reaction in the lungs. Gastroesophageal reflux disease and other esophageal abnormalities have often been associated with this disease.

Case presentation

We herein report the case of an 83-year-old patient in whom a follow-up chest computed tomography scan, for a lingular consolidation, showed multifocal ground glass and consolidative opacities with areas of low attenuation, suggestive of exogenous lipid pneumonia. The patient had been on piascledine capsules (avocado/soybean unsaponifiables) for 20 years and had a hiatal hernia with documented gastroesophageal reflux disease. After thorough history taking, no other predisposing factors were found. The diagnosis was confirmed using oil red staining of bronchoalveolar lavage showing lipid-laden macrophages and extracellular lipid droplets.

Conclusions

To our knowledge, this is the first case of ELP secondary to avocado/soybean unsaponifiables in the literature.
Literature
1.
go back to reference Gondouin A, Manzoni P, Ranfaing E, Brun J, Cadranel J, Sadoun D, et al. Exogenous lipid pneumonia: a retrospective multicentre study of 44 cases in France. Eur Respir J. 1996;9(7):1463–9.CrossRef Gondouin A, Manzoni P, Ranfaing E, Brun J, Cadranel J, Sadoun D, et al. Exogenous lipid pneumonia: a retrospective multicentre study of 44 cases in France. Eur Respir J. 1996;9(7):1463–9.CrossRef
2.
go back to reference Betancourt SL, Martinez-Jimenez S, Rossi SE, Truong MT, Carrillo J, Erasmus JJ. Lipoid pneumonia: Spectrum of clinical and radiologic manifestations. Am J Roentgenol. 2010;194(1):103–9.CrossRef Betancourt SL, Martinez-Jimenez S, Rossi SE, Truong MT, Carrillo J, Erasmus JJ. Lipoid pneumonia: Spectrum of clinical and radiologic manifestations. Am J Roentgenol. 2010;194(1):103–9.CrossRef
3.
go back to reference Laurent F, Philippe JC, Vergier B, Granger-Veron B, Darpeix B, Vergeret J, et al. Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings. Eur Radiol. 1999;9(6):1190–6.CrossRef Laurent F, Philippe JC, Vergier B, Granger-Veron B, Darpeix B, Vergeret J, et al. Exogenous lipoid pneumonia: HRCT, MR, and pathologic findings. Eur Radiol. 1999;9(6):1190–6.CrossRef
4.
go back to reference Hadda V, Khilnani GC. Lipoid pneumonia: an overview. Expert Rev Respir Med. 2010;4(6):799–807.CrossRef Hadda V, Khilnani GC. Lipoid pneumonia: an overview. Expert Rev Respir Med. 2010;4(6):799–807.CrossRef
5.
6.
go back to reference Marchiori E, Zanetti G, Mano CM, Hochhegger B. Exogenous lipoid pneumonia. Clinical and radiological manifestations. Respir Med. 2011;105(5):659–66.CrossRef Marchiori E, Zanetti G, Mano CM, Hochhegger B. Exogenous lipoid pneumonia. Clinical and radiological manifestations. Respir Med. 2011;105(5):659–66.CrossRef
7.
go back to reference Kilaru H, Prasad S, Radha S, Nallagonda R, Kilaru SC, Nandury EC. Nasal application of petrolatum ointment - a silent cause of exogenous lipoid pneumonia: successfully treated with prednisolone. Respir Med Case Rep. 2017;22:98–100.PubMedPubMedCentral Kilaru H, Prasad S, Radha S, Nallagonda R, Kilaru SC, Nandury EC. Nasal application of petrolatum ointment - a silent cause of exogenous lipoid pneumonia: successfully treated with prednisolone. Respir Med Case Rep. 2017;22:98–100.PubMedPubMedCentral
9.
go back to reference Madan K, Walia R, Kumar J, Jain D, Guleria R, Venkatnarayan K. “Diesel siphoner′s lung”: Exogenous lipoid pneumonia following hydrocarbon aspiration. Lung India. 2014;31(1):63.CrossRef Madan K, Walia R, Kumar J, Jain D, Guleria R, Venkatnarayan K. “Diesel siphoner′s lung”: Exogenous lipoid pneumonia following hydrocarbon aspiration. Lung India. 2014;31(1):63.CrossRef
10.
go back to reference Rabahi MF, Ferreira AA, Madeira JGP, Galvao PM, Pinto SA. Pneumonia lipoide secundária ao uso prolongado de óleo de prímula. J Bras Pneumol. 2010;36(5):657–61.CrossRef Rabahi MF, Ferreira AA, Madeira JGP, Galvao PM, Pinto SA. Pneumonia lipoide secundária ao uso prolongado de óleo de prímula. J Bras Pneumol. 2010;36(5):657–61.CrossRef
11.
go back to reference Steinberg I. Lipoid pneumonia associated with Paraesophageal hernia: Angiocardiographic study of a case. Diseases of the Chest. 1960;37(2):157–62.CrossRef Steinberg I. Lipoid pneumonia associated with Paraesophageal hernia: Angiocardiographic study of a case. Diseases of the Chest. 1960;37(2):157–62.CrossRef
12.
go back to reference Nguyen CD, Oh SS. A Case of Exogenous Lipoid Pneumonia. Respir Care. 2013;58:23–7. Nguyen CD, Oh SS. A Case of Exogenous Lipoid Pneumonia. Respir Care. 2013;58:23–7.
13.
go back to reference Knauer-Fischer S, Ratjen F. Lipid-laden macrophages in bronchoalveolar lavage fluid as a marker for pulmonary aspiration. Pediatr Pulmonol. 1999;27(6):419–22.CrossRef Knauer-Fischer S, Ratjen F. Lipid-laden macrophages in bronchoalveolar lavage fluid as a marker for pulmonary aspiration. Pediatr Pulmonol. 1999;27(6):419–22.CrossRef
14.
go back to reference Marchiori E, Zanetti G, Nobre LF, Takayassu TC, Irion KL. Lipoid pneumonia complicating Megaesophagus secondary to Chagas disease: high-resolution computed tomography findings. J Thorac Imaging. 2010;25(2):179–82.CrossRef Marchiori E, Zanetti G, Nobre LF, Takayassu TC, Irion KL. Lipoid pneumonia complicating Megaesophagus secondary to Chagas disease: high-resolution computed tomography findings. J Thorac Imaging. 2010;25(2):179–82.CrossRef
15.
go back to reference Olivier P, Montastruc J-L. Profil d’effets indésirables des insaponifiables d’avocat et de soja. Presse Med. 2010;39(10):e211–6.CrossRef Olivier P, Montastruc J-L. Profil d’effets indésirables des insaponifiables d’avocat et de soja. Presse Med. 2010;39(10):e211–6.CrossRef
16.
go back to reference Pavelka K, Coste P, Géher P, Krejci G. Efficacy and safety of piascledine 300 versus chondroitin sulfate in a 6 months treatment plus 2 months observation in patients with osteoarthritis of the knee. Clin Rheumatol. 2010 Jun;29(6):659–70.CrossRef Pavelka K, Coste P, Géher P, Krejci G. Efficacy and safety of piascledine 300 versus chondroitin sulfate in a 6 months treatment plus 2 months observation in patients with osteoarthritis of the knee. Clin Rheumatol. 2010 Jun;29(6):659–70.CrossRef
19.
go back to reference Talwar A, Mayerhoff R, London D, Shah R, Stanek A, Epstein M. False-Positive PET Scan in a Patient With Lipoid Pneumonia Simulating Lung Cancer. Clin Nucl Med. 2004;29(7):426–8.CrossRef Talwar A, Mayerhoff R, London D, Shah R, Stanek A, Epstein M. False-Positive PET Scan in a Patient With Lipoid Pneumonia Simulating Lung Cancer. Clin Nucl Med. 2004;29(7):426–8.CrossRef
20.
go back to reference Mokhlesi B, Angulo-Zereceda D, Yaghmai V. False-positive FDG-PET scan secondary to lipoid pneumonia mimicking a solid pulmonary nodule. Ann Nucl Med. 2007;21(7):411–4.CrossRef Mokhlesi B, Angulo-Zereceda D, Yaghmai V. False-positive FDG-PET scan secondary to lipoid pneumonia mimicking a solid pulmonary nodule. Ann Nucl Med. 2007;21(7):411–4.CrossRef
Metadata
Title
A case report of exogenous lipoid pneumonia associated with avocado/soybean unsaponifiables
Authors
Jacques BOUTROS
Marine MUZZONE
Jonathan BENZAQUEN
Michael LEVRAUT
Charles-Hugo MARQUETTE
Fanny ROCHER
Yann DIASCORN
Bernard PADOVANI
Véronique HOFMAN
Sylvie LEROY
Publication date
01-12-2019

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