A case report of exogenous lipoid pneumonia associated with avocado/soybean unsaponifiables

BMC Pulm Med. 2019 Dec 3;19(1):234. doi: 10.1186/s12890-019-0997-1.

Abstract

Background: Exogenous lipoid pneumonia is a rare disease resulting from intra-alveolar accumulation of lipids of mineral, vegetal, or animal origin, that induce a foreign body type of inflammatory reaction in the lungs. Gastroesophageal reflux disease and other esophageal abnormalities have often been associated with this disease.

Case presentation: We herein report the case of an 83-year-old patient in whom a follow-up chest computed tomography scan, for a lingular consolidation, showed multifocal ground glass and consolidative opacities with areas of low attenuation, suggestive of exogenous lipid pneumonia. The patient had been on piascledine capsules (avocado/soybean unsaponifiables) for 20 years and had a hiatal hernia with documented gastroesophageal reflux disease. After thorough history taking, no other predisposing factors were found. The diagnosis was confirmed using oil red staining of bronchoalveolar lavage showing lipid-laden macrophages and extracellular lipid droplets.

Conclusions: To our knowledge, this is the first case of ELP secondary to avocado/soybean unsaponifiables in the literature.

Keywords: Avocado oil; Exogenous lipoid pneumonia; Gastroesophageal reflux disease; Hiatal hernia; Soybean oil.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Female
  • Glycine max*
  • Humans
  • Persea*
  • Plant Extracts / adverse effects*
  • Pneumonia, Lipid / chemically induced*

Substances

  • Plant Extracts