Summary
Introduction:
This text is a case report of a patient with hypersensitivity pneumonitis (hP) caused by exposure to secondhand smoke from electronic cigarettes (e-cigarettes). The report also discusses the potential chemicals and microbial agents in e-cigarettes that may cause hP. The reader will learn about the diagnostic process, management, and the possibility of hP development from passive exposure to e-cigarettes.
Key Points:
* The patient is a never-smoker with a history of premature birth, diagnosed with hP after experiencing persistent wheezing and dyspnea on exertion.
* The diagnosis was challenging, requiring a thorough review of antigen exposure, laboratory tests, imaging, and lung biopsy.
* The differential diagnosis was limited to sarcoidosis or hP.
* The patient's partner used e-cigarettes, and the secondhand aerosol exposure was identified as the most likely cause of hP.
* Steroids were initiated, and avoidance of e-cigarette aerosol was strongly recommended.
* after 6 months of high-dose steroids and avoiding secondhand smoke exposure, the patient's dyspnea on exertion resolved, and pulmonary function tests remained stable.
* The text also discusses the potential chemicals (e.g., isocyanates) and microbial agents (e.g., nontuberculosis mycobacteria) in e-cigarettes that may cause hP.
Main Message:
This case report highlights the potential risk of developing hP from passive exposure to e-cigarettes. healthcare professionals should be aware of this risk and consider e-cigarettes as a possible cause of hP, especially in patients with respiratory symptoms and a history of exposure to e-cigarette aerosol. Further studies are needed to understand the composition of secondhand aerosol from e-cigarettes and its potential health effects. In the meantime, avoiding exposure to e-cigarette aerosol, both first-hand and secondhand, is crucial for preventing hP and other respiratory illnesses.
Citation
Galiatsatos P, Gomez E, Lin CT, Illei PB, Shah P, Neptune E. Secondhand smoke from electronic cigarette resulting in hypersensitivity pneumonitis. BMJ case reports. 2020;13(3). doi:10.1136/bcr-2019-233381
