Lipid pneumonia is a specific form of lung inflammation (pneumonia) that develops when lipids enter the bronchial tree. The disorder is sometimes called cholesterol pneumonia in cases where that lipid is a factor.[1]
Signs and symptoms
The pneumonia presents as a foreign body reaction causing cough, dyspnea, and often fever. Hemoptysis has also been reported.[2]
Causes
Sources of such lipids could be either exogenous or endogenous.[3]
Exogenous
From outside the body. For example, inhaled nose drops with an oil base, or accidental inhalation of cosmetic oil. Amiodarone is an anti-arrythmic known to cause this condition. Oil pulling has also been shown to be a cause.[4]Fire breather's pneumonia from the inhalation of hydrocarbon fuel is a specific variant. At risk populations include the elderly, developmentally delayed or persons with gastroesophageal reflux. Switching to water-soluble alternatives may be helpful in some situations.[2]
The gross appearance of a lipid pneumonia is that in which there is an ill-defined, pale yellow area on the lung. This yellow appearance explains the colloquial term "golden" pneumonia.[7]
At the microscopic scale foamy macrophages and giant cells are seen in the airways, and the inflammatory response is visible in the parenchyma.[citation needed]
On CT, lipoid pneumonia appears as a "crazy paving" pattern, characterized by ground glass opacities with interspersed interlobular septal thickening.[8]
Diagnosis
Lipid pneumonia-exogenous
In terms of the evaluation of Lipid pneumonia we find the following:[9]
There are no specific guidelines for the treatment of the disease. Limited evidence suggest that the corticosteroids and possibly intravenous immunoglobulins may improve condition but in the case of exogenous type the stopping of the offending agent is the step that should be taken first.[9]
Prognosis
Endogenous lipoid pneumonia and non-specific interstitial pneumonitis has been seen prior to the development of pulmonary alveolar proteinosis in a child.[6]
Epidemiology
Lipid pneumonia has been known to occur in underwater divers after breathing poorly filtered air supplied by a surface compressor lubricated by mineral oil.[10]
This section needs expansion. You can help by adding to it. (September 2022)
History
Laughlen first described lipid pneumonia in 1925 with infants that inhaled oil droplets.[10] It is a condition that has been seen as an occupational risk for commercial diving operations but documented cases are rare.[10]
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