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 The case, published on Thursday in the Canadian Medical Association
Journal, involved a 17-year-old male who developed a form of
bronchiolitis, a serious and irreversible lung injury caused by
chemical exposure.
The condition has been linked to diacetyl, the chemical that gives
microwave popcorn its buttery flavor and a known cause of
bronchiolitis. Various studies have also found diacetyl in vaping
liquids.
The previously healthy Canadian teen turned up in the emergency
department of a community hospital in Ontario last spring with a
severe cough. He was diagnosed with pneumonia and prescribed
antibiotics.
Five days later, he was back with worsening symptoms and was
admitted and given intravenous antibiotics. He continued to decline
and was put on a mechanical ventilator, but still failed to improve.
At that point, he was transferred to London Health Sciences Centre
and put on an extracorporeal membrane oxygenation, or ECMO, machine
- an extreme treatment that takes over the work of the lungs. That
stabilized him, but did not reverse the condition.
"I was concerned his lungs might never recover enough to get him off
the machine," said Dr. Karen Bosma, a London Health intensive care
physician and a study author.
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Fearing he might need a lung transplant, the team transferred the
teen to a regional transplant center in Toronto. Since testing had
ruled out infection, doctors decided to try high-dose steroids,
which helped reduce inflammation.
The patient had reported using both flavored nicotine vapes and THC
- the psychoactive agent in marijuana. Doctors suspected a vaping-related
injury, even before the U.S. outbreak had been reported.
Although the case shares similarities with the more than 2,000 cases
of vaping-related illnesses in the United States, the injury is
different. Instead of damaged air sacs in the lungs, the teen had
damaged airways, which his doctors believe were caused by chemical
injury.
"This is a new finding," Bosma said.
Several vaping chemicals could have caused the injury, she said, but
the team focused on diacetyl because it has been shown to cause
similar illnesses.
Four months after his discharge, the teen still has trouble
breathing. Bosma said it is not clear if his lungs will recover.
"In patients with popcorn lung, it's irreversible."
(Reporting by Julie Steenhuysen; Editing by Bill Berkrot)
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