Clinical, radiological and therapeutic features of exogenous lipoid pneumonia.

Abstract

Introduction: Lipoid pneumonia is a rare disease affecting adults' which frequency increases with age. Exogenous lipoid pneumonia results from the penetration, usually by inhalation, of oily substances into the pulmonary parenchyma.

Aim: To study the clinical and radiological features of exogenous lipoid pneumonia and to define therapeutic strategies.

Methods: We performed a monocentric, retrospective study of patients followed in the Pneumology Department of the Hedi Chaker Hospital in Sfax between 2004 and 2023. The diagnosis of exogenous lipoid pneumonia was confirmed by bronchoalveolar lavage with positive Oil Red O staining or by biopsy with anatomopathological examination showing lipid-laden foamy histiocytes.

Results: During this period, we collected nine patients with an average age of 46. Dyspnea and cough were the most frequent symptoms. Chest computed tomography revealed ground-glass opacity in five cases, parenchymal condensations in three cases and crazy paving in three cases. The frequent risk factors were occupational exposure to a lipid in five cases and consumption of a lipid product in four cases. In terms of treatment, four patients underwent occupational reclassification and a declaration of occupational disease. Systemic corticotherapy was indicated in six patients.

Conclusion: Exogenous lipoid pneumonia is a rare entity. This study highlights the difficulty of making a diagnosis, due to misleading clinico-radiological presentation in the absence of exposure.