Abstract
Isıtılmış tütün ürünleri elektronik olarak kontrol edilen bir ısıtma sistemi ile tütün yakmadan nikotin açığa çıkaran ürünlerdir. 56 yaşında erkek hasta ani başlangıçlı nefes darlığı ve göğüs ağrısı şikayetleriyle başvurdu. 2,5 yıldır ısıtılmış tütün ürünü (I quit ordinary smoking, IQOS) kullanıyordu. Toraks bilgisayarlı tomografi tetkikinde sağ akciğer alt lobda plevra tabanlı atelektazi ve fibroatelektatik değişiklikler, sağ üst lobda plevral sıvı, sol akciğerde fibroatelektatik değişiklikler ve plevral kalınlaşma izlendi. Video yardımlı toraks cerrahisi (video-assisted thoracic surgery, VATS) ile alınan biyopsi de akciğerde nodüler halinde lenfoid agregasyon ve çevresinde yaygın antrakoz, alveol içinde ışığı çift kıran fibriler materyal, alveol içinde hyalin membran benzeri materyal, tip 2 pnömosit hiperplazisi, interstisyel bir organizasyon ve ekzojen lipoid materyalin izlenmekte olduğu bir subakut akciğer hasarı tablosu izlendi. Bu bulgular toksik madde kaynaklı kimyasal pnömoni ile uyumlu olarak değerlendirildi. Bunun hastanın 2,5 yıllık ısıtılmış tütün kullanımına bağlı olduğu düşünüldü.
Keywords
References
- Caraballo RS, Pederson LL, Gupta N. New tobacco products: do smokers like them? Tob Control 2006;15(1):39-44.
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- Butt YM, Smith ML, Tazelaar HD, Vaszar LT, Swanson KL, Cecchini MJ, et al. Pathology of vaping-associated lung injury. N Engl J Med. 2019;381(18):1780-1.
- Leigh NJ, Palumbo MN, Marino AM, O'Connor RJ, Goniewicz ML. Tobacco-specific nitrosamines (TSNA) in heated tobacco product IQOS. Tob Control. 2018;27(Suppl 1):s37-8.
- Marsden L, Michalicek ZD, Christensen ED. More on the pathology of vaping-associated lung injury. N Engl J Med. 2020;382(4):387-8.
- Davidson KR, Fox DL. More on the pathology of vaping-associated lung injury. N Engl J Med. 2020;382(4):388.
- Larsen BT, Butt YM, Smith ML. More on the pathology of vaping-associated lung injury. Reply. N Engl J Med. 2020;382(4):388-90.
Abstract
Heated tobacco products release nicotine without burning tobacco with an electronically controlled heating system. 56-year-old male patient admitted with sudden onset of chest pain and shortness of breath. He had been using a heated tobacco product (I quit ordinary smoking, IQOS) for 2.5 years. Thoracic computed tomography scan revealed pleural-based atelectasis and fibroatelectatic changes in the lower lobe of the right lung, pleural fluid in the right upper lobe, fibroatelectatic changes and pleural thickening in the left lung. Biopsy taken with video-assisted thoracic surgery (VATS) showed lymphoid aggregation in nodular form and widespread anthracosis around the lung, fibrillar material that double-refracting the light in the alveoli, hyaline membrane-like material in the alveoli, type 2 pneumocyte hyperplasia, an interstitial organization, and a subacute lung injury picture with exogenous lipoid material. These findings were evaluated in accordance with toxic substance-induced chemical pneumonia. It was thought that it might be related to 2.5 years of using heated tobacco product.
Keywords
References
- Caraballo RS, Pederson LL, Gupta N. New tobacco products: do smokers like them? Tob Control 2006;15(1):39-44.
- Goniewicz ML, Knysak J, Gawron M, Kosmider L, Sobczak A, Kurek J, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control 2014;23(2):133-9.
- Kim M. Philip Morris International introduces new heat-not-burn product, IQOS, in South Korea. Tob Control. 2018;27(e1):e76-8.
- Leigh NJ, Tran PL, O’Connor RJ, Goniewicz ML. Cytotoxic effects of heated tobacco products (HTP) on human bronchial epithelial cells. Tob Control. 2018;27(Suppl 1):s26-9.
- Kligerman S, Raptis C, Larsen B, Henry TS, Caporale A, Tazelaar H, et al. Radiologic, pathologic, clinical, and physiologic findings of electronic cigarette or vaping product use-associated lung injury (EVALI): Evolving knowledge and remaining questions. Radiology. 2020;294(3):491-505.
- Butt YM, Smith ML, Tazelaar HD, Vaszar LT, Swanson KL, Cecchini MJ, et al. Pathology of vaping-associated lung injury. N Engl J Med. 2019;381(18):1780-1.
- Leigh NJ, Palumbo MN, Marino AM, O'Connor RJ, Goniewicz ML. Tobacco-specific nitrosamines (TSNA) in heated tobacco product IQOS. Tob Control. 2018;27(Suppl 1):s37-8.
- Marsden L, Michalicek ZD, Christensen ED. More on the pathology of vaping-associated lung injury. N Engl J Med. 2020;382(4):387-8.
- Davidson KR, Fox DL. More on the pathology of vaping-associated lung injury. N Engl J Med. 2020;382(4):388.
- Larsen BT, Butt YM, Smith ML. More on the pathology of vaping-associated lung injury. Reply. N Engl J Med. 2020;382(4):388-90.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Case Report |
| Authors | |
| Publication Date | August 30, 2021 |
| Submission Date | March 15, 2021 |
| Published in Issue | Year 2021 Volume: 23 Issue: 2 |
Cite
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