Because there is not a "standardized case definition for vaping-associated lung injury," wrote lead author Travis S. Henry from the University of California San Francisco, "the diagnosis of lung injury due to vaping may be made by establishing a temporal relationship between change in vaping habits and onset of lung disease, exclusion of other causes of lung disease (e.g., infection, other drug or exposure, connective tissue disease, and so on), and stabilization or improvement with cessation of vaping and possibly with corticosteroid treatment."
Stressing the importance of recognizing the following patterns seen with ENDS, Henry et al. note that the radiologist may be the first person to prompt the clinical team to ask about relevant exposures:
Findings - CT - Ground-glass - Opacity - GGO
Typical findings on CT include symmetric upper lung-predominant and midlung-predominant ground-glass opacity (GGO), poorly defined centrilobular nodules, and occasionally mosaic attenuation reflective of air trapping. Henry and team observed improvement after cessation of antigen inhalation.
Although chest radiography or CT alone is not sufficient to distinguish from other causes of acute lung opacities -- aspiration, edema, infection, etc. -- patients may be anemic, and bronchoalveolar lavage (BAL) with persistent or increasingly bloody aliquots can confirm diagnosis.
Vape - Usage - Use - Increase - Brand
Often secondary to first-time vape usage, use increase, brand change, or resumption of traditional smoking...
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