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Le cas d’un vapoteur canadien expose un nouveau type de l?sions pulmonaires

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  • Le cas d’un vapoteur canadien expose un nouveau type de l?sions pulmonaires

    Le cas d’un vapoteur canadien expose un nouveau type de l?sions pulmonaires
    ...
    Radio-Canada
    Publi? ? 0 h 27

    Un adolescent ontarien qui s’est retrouv? aux soins intensifs apr?s avoir vapot? intens?ment pendant cinq mois souffrait d’une inflammation grave des voies respiratoires diff?rente des cas rapport?s jusqu'ici au Canada et aux ?tats-Unis.

    Cette conclusion a amen? le Canadian Medical Association Journal ? publier jeudi un article sur ce cas unique. L’?diteur adjoint du journal estime qu’il ?tait important d’alerter le public ? ce sujet. C’est le canari dans la mine, explique-t-on.
    ...
    Plus de 2000 cas de probl?mes pulmonaires graves li?s ? la cigarette ?lectronique, qui ont tu? 42 personnes, ont ?t? recens?s aux ?tats-Unis. Le Canada compte pour sa part sept cas confirm?s ou probables. Mais ce cas serait diff?rent.

    Le gar?on de 17 ans, qui est tomb? gravement malade en Ontario, fumait de la marijuana et des cigarettes ?lectroniques aromatis?es.

    Les liquides aux diff?rents parfums qui sont vendus pour les vapoteuses contiennent souvent du diac?tyle. Ce produit chimique entre aussi dans la composition du ma?s souffl? ? chauffer au micro-ondes.

    Dans le pass?, des travailleurs d'usine qui fabriquaient du ma?s souffl? pour le micro-ondes ont ?t? atteints de bronchiolite, une inflammation aigu? des petites ramifications des bronches.

    Nous savions que cette substance chimique pouvait causer cette maladie, nous savions qu'elle se retrouvait dans les liquides pour les vapoteuses, raconte le Dr Stanbrook. Nous nous attendions ? la diagnostiquer chez un patient t?t ou tard, et maintenant, ?a semble bien ?tre le cas.

    ...
    Un adolescent ontarien qui s’est retrouvé aux soins intensifs après avoir vapoté intensément pendant cinq mois souffrait d’une inflammation grave des voies respiratoires différente des cas rapportés jusqu'ici au Canada et aux États-Unis.


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    Voir aussi (Anglais seulement):

    Life-threatening bronchiolitis related to electronic cigarette use in a Canadian youth

    BACKGROUND: Although electronic cigarettes (e-cigarettes) were initially marketed as a potential smoking-cessation aid and a safer alternative to smoking, the long-term health effect of e-cigarette use (“vaping”) is unknown. Vaping e-liquids expose the user to several potentially harmful chemicals, including diacetyl, a flavouring compound known to cause bronchiolitis obliterans with inhalational exposure (“popcorn worker’s lung”). CASE DESCRIPTION: We report the case of a 17-year-old male who presented with intractable cough, progressive dyspnea and malaise after vaping flavoured e-liquids and tetrahydrocannabinol intensively. Initial physical examination showed fever, tachycardia, hypoxemia, and bibasilar inspiratory crackles on lung auscultation. Computed tomography of the chest showed diffuse centrilobular “tree-inbud” nodularity, consistent with acute bronchiolitis. Multiple cultures, including from 2 bronchoalveolar lavage samples, and biopsy stains, were negative for infection. He required intubation, invasive mechanical ventilation and venovenous extracorporeal membrane oxygenation (ECMO) for refractory hypercapnia. The patient’s condition improved with high-dose corticosteroids. He was weaned off ECMO and mechanical ventilation, and discharged home after 47 days in hospital. Several months after hospital discharge, his exercise tolerance remained limited and pulmonary function tests showed persistent, fixed airflow obstruction with gas trapping. The patient’s clinical picture was suggestive of possible bronchiolitis obliterans, thought to be secondary to inhalation of flavouring agents in the e-liquids, although the exact mechanism of injury and causative agent are unknown. INTERPRETATION: This case of severe acute bronchiolitis, causing near-fatal hypercapnic respiratory failure and chronic airflow obstruction in a previously healthy Canadian youth, may represent vaping-associated bronchiolitis obliterans. This novel pattern of pulmonary disease associated with vaping appears distinct from the type of alveolar injury predominantly reported in the recent outbreak of cases of vaping-associated pulmonary illness in the United States, underscoring the need for further research into all potentially toxic components of e-liquids and tighter regulation of e-cigarettes. [See related article at [www.cmaj.ca/lookup/doi/10.1503/cmaj.191503][2]][2] []: /lookup/volpage/191/E1319

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