Eight years ago, long before the current health scare from e-cigarettes, a pulmonologist at Legacy Health in Portland, Ore., documented a case of vaping-related pneumonia.
A 42-year-old woman was admitted to Legacy Good Samaritan Hospital after shortness of breath, cough and fevers. Her respiratory symptoms had started about seven months earlier, when she began using e-cigarettes.
Dr. Catherine Markin and two colleagues wrote about the case in the April 2012 issue of Chest, published by the American College of Chest Physicians. The patient had lipoid pneumonia, a rare condition that occurs when fat is deposited into the lung tissue. The suspected source was “recurrent exposure to glycerin-based oils found in e-cigarette nicotine vapor,” according to the study.
“It was a hypothesis, 'An Unexpected Consequence of Electronic Cigarette Use,'” Markin said. “We had no other explanation at the time for her lipoid pneumonia.”
Markin said the patient was treated with steroids and recovered.
The case didn’t generate a lot of national attention at the time. But Markin's not surprised that more cases have cropped up since.
State and federal health officials have in recent weeks warned the public about the dangers of vaping. There have been six deaths associated with a severe lung illness linked to e-cigarettes. Nearly 400 cases of the illness have been confirmed in 36 states, prompting calls to ban flavored e-cigarettes, which appeal to minors.
Some of the cases involved vaping products containing cannabis, but not all.
Markin suspects the vaping juice is to blame, as well as the dosage.
“As a lung specialist, I advise all my patients not to inhale anything into their lungs other than medications and clean air,” she said. “We don’t know enough about vaping to know the long-term health effects.”
There could have been other, scattered cases in recent years before the current outbreak and besides the case at Legacy Emanuel. In 2016, Markin came across another case of someone in their 30s hospitalized at Legacy Meridian Park Hospital who was a heavy vaper and had developed lipoid pneumonia.
She had used strawberry vaping juice, which she said “made it good and enhanced the flavor,” Markin said.
While there have been studies that supported the use of vaping to wean off of regular cigarettes, there is also evidence that nicotine-heavy e-cigarettes are a gateway to cigarettes for young people, Markin said.
“I’m a lung doctor, so you wouldn’t be getting your money’s worth unless I told you, don’t vape, don’t smoke,” she said. “We don’t know who’s at particular risk, what’s causing it, so the best advice is not to start and, if you’re using it, to stop.”
