a comparative analysis of acute eosinophilic pneumonia associated with smoking and vaping.

Introduction:
This letter to the editor presents a comparative analysis of acute eosinophilic pneumonia (aEP) associated with smoking and vaping. The study aims to compare the similarities and dissimilarities between patients diagnosed with smoking-associated aEP (Sa-aEP) and vaping-associated aEP (Va-aEP). The text provides valuable insights into the clinical, laboratory, and radiologic aspects of aEP in smoking and vaping.

Key Points:

* The study included 24 patients, 15 with Sa-aEP and 9 with Va-aEP.
* Patients in both groups were young and predominantly male.
* Patients with Va-aEP had a non-statistically significant longer duration of vaping than smokers.
* Sa-aEP patients were more likely to have fever and sputum production.
* There were no significant differences in WBC count, initial and maximum PBE levels, days with the highest eosinophil levels, pleural effusion, CRP levels, and BaL levels of eosinophils, lymphocytes, neutrophils, or macrophages between the two groups.
* all patients were treated with corticosteroids and recovered rapidly.
* a similar number of patients in both groups required mechanical ventilation.
* The study revealed a strong positive correlation between the duration of symptoms and initial PBE levels for the entire cohort.

Main Message:
The main message of this study is that the clinical, laboratory, and radiologic aspects of Sa-aEP and Va-aEP are comparable, except for a higher likelihood of fever and sputum production in smokers. The study also highlights the importance of considering aEP in the differential diagnosis of respiratory failure in both smoking and vaping patients. Furthermore, the authors suggest that the pathophysiology of aEP may not be dependent on the specific offending agent but a common inflammatory response following lung injury after exposure. This finding has significant implications for understanding the underlying mechanisms of aEP and developing effective treatments for this rare but severe respiratory condition.

Bonnier a, Saha S, Shkolnik B, Saha BK. a comparative analysis of acute eosinophilic pneumonia associated with smoking and vaping. The american journal of the medical sciences. 2023;365(3):315-317. doi:10.1016/j.amjms.2022.10.003