Research Day
TWO TEENS WITH VAPING ASSOCIATED LUNG INJURY IN A COMMUNITY CHILDREN'S HOSPITAL
Document Type
Abstract
Date
2021
Abstract
Electronic-cigarettes or vaping associated lung injury (EVALI) had a sharp increase in cases in 2019 linked to Vitamin E acetate additive in tetrahydrocannabinol containing products. Diagnostic criteria and management remain limited to case series. Here we present a case series of two patients diagnosed with EVALI after admission to our community children's hospital with non-specific symptoms.
Case description: A 17-year-old previously healthy male presents with one week of worsening abdominal pain, intractable vomiting, fever, night sweats, chest pain and dyspnea with exertion. History of chronic diarrhea and significant unintentional weight loss. Baseline labs inflammatory markers were elevated. Chest XR remarkable for peri-bronchial disease. CT scan of chest showed patchy ground glass pulmonary opacities and small volume ascites. 15-year-old male with history of five days of nausea, vomiting, diarrhea, abdominal pain and unintentional 15 lb weight loss. Physical exam significant for jaundice and had tenderness to palpation over right upper quadrant. Initial labs were significant for transaminitis and elevated CRP and ESR. Chest x-ray showed interstitial edema and small pleural effusions. Later both patients endorsed vaping THC based cartridges for 1-2 years. Mainstream therapy included supportive treatment, supplemental oxygen and steroids. Improvement of symptoms was noted within 24-48 hours since initiation of steroids.
Discussion: Vaping products are popular within the adolescent population. Even though dyspnea is the most commonly reported presenting symptom, in our two patients gastrointestinal preceded respiratory symptoms. More research needs to be conducted toestablish standardized diagnostic criteria and management to promote early diagnosis and prevent further deterioration.