We read with great interest the enlightening article by Ansari-Gilani et al. published in your esteemed journal highlighting 3 alleged cases of E-cigarette use related lung diseases.
1.However, upon reading the article carefully, it raises some concerns regarding the diagnosis. In the first case, the authors describe the extensive work up done for a patient who had chronic dyspnea, abnormal chest imaging 10 months prior to the index hospitalization and poorly defined granulomas on histopathological examination. Findings of granulomas and organizing pneumonia on histopathology are quite nonspecific. Recently published distinguished reviews explaining lung biopsy findings in vaping associated pulmonary illness favored interstitial thickening, diffuse alveolar damage and organizing pneumonia.
- Ansari-Gilani K.
- Petraszko A.M.
- Teba C.V.
- Reeves A.R.
- Gupta A.
- Gupta A.
- et al.
E-cigarette use related lung disease, review of clinical and imaging findings in 3 cases.
Heart Lung. 2020; ([Epub ahead of print])
- Mukhopadhyay S.
- Mehrad M.
- Dammert P.
- Arrossi A.V.
- Sarda R.
- Brenner D.S.
- et al.
Lung biopsy findings in severe pulmonary illness associated with E-Cigarette use (Vaping): a report of eight cases.
Am J Clin Pathol. 2019; 153: 30-39
3.Interestingly neither of the above papers reported “granulomas” as a finding in histopathological samples of patients with vaping associated lung injury. In their report, authors provided no information about the histopathological analysis for patient 2 and 3.
- Butt Y.M.
- Smith M.L.
- Tazelaar H.D.
- Vaszar L.T.
- Swanson K.L.
- Cecchini M.J.
- et al.
Pathology of vaping-associated lung injury.
New Engl J Med. 2019; 381: 1780-1781
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- E-cigarette use related lung disease, review of clinical and imaging findings in 3 cases.Heart Lung. 2020; ([Epub ahead of print])
- Lung biopsy findings in severe pulmonary illness associated with E-Cigarette use (Vaping): a report of eight cases.Am J Clin Pathol. 2019; 153: 30-39
- Pathology of vaping-associated lung injury.New Engl J Med. 2019; 381: 1780-1781
- Pulmonary illness related to E-Cigarette use in illinois and wisconsin — preliminary report.New Engl JMed. 2019; ([Epub ahead of print])
- Recurrent pulmonary embolism and hypersensitivity pneumonitis secondary to aspergillus, in a compost plant worker: case report and review of literature.Lung. 2018; 196: 553-560
- Vitamin e acetate and E-Cigarette or vaping product-associated lung injury (EVALI): an update.Am J Med. 2019; ([Epub ahead of print])
- A double-edged sword: e-cigarettes, and other electronic nicotine delivery systems (ENDS).Intern Emerg Med. 2019; ([Epub ahead of print])
- E-Cigarettes and Methemoglobinemia: A Wolf in Sheep’s Clothing.The American Journal of Medicine. 2019; 132: e759https://doi.org/10.1016/j.amjmed.2019.06.009
Published online: February 25, 2020
Accepted: February 7, 2020
Received: February 4, 2020
Verification: All authors have seen the manuscript and agree to the content and data. All the authors played a significant role in the paper.
© 2020 Elsevier Inc. All rights reserved.