By Julie Steenhuysen
(Reuters) – Researchers in Canada have identified a new type of vaping-related lung injury that they believe is linked to flavors in conventional vape pens, causing symptoms similar to the "popcorn-lung injury" seen in workers exposed to flavors in microwave popcorn.
The case, published on Thursday in the Canadian Medical Association Journal, involved a 17-year-old man 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 taste and a known cause of bronchiolitis. Various studies have also found diacetyl in vapors.
The former healthy Canadian teenager showed up at the emergency department at 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 given intravenous antibiotics. He continued to reduce and put on a mechanical fan, but still failed to improve.
At that time he was transferred to the London Health Sciences Center and put on an extracorporeal membrane oxidation, or ECMO, a machine – an extreme treatment that takes over the work of the lung. It stabilized him, but did not reverse the condition.
"I was worried that his lungs would never be able to recover enough to get him out of the machine," Dr. Karen Bosma, a physician in London for intensive care and a study author.
Fearing that he might need a lung transplant, the team transferred the teen to a regional transplant center in Toronto. Because tests had ruled out infection, doctors decided to try high-dose steroids, which helped reduce inflammation.
The patient had reported using both flavored nicotine vapor and THC – the psychoactive agent in marijuana. Doctors suspected a gun-related injury, even before the American outbreak was reported.
Although the case shares similarities with the more than 2,000 cases of vaping-related illnesses in the United States, the damage is different. Instead of damaged air sacs in the lungs, the teen had damaged the airways, which his doctor believes were caused by chemical damage.
"This is a new find," Bosma said.
Several vaping chemicals could have caused the injury, she said, but the team focused on diacetyl as it has been found to cause similar illnesses.
Four months after his discharge, the teens still have difficulty breathing. Bosma said it's not clear if his lungs will recover.
"In patients with popcorn lung, it is irreversible."
(Reporting by Julie Steenhuysen; Editing by Bill Berkrot)