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Choi, Kwag, Chae, Lim, and Lim: Severe Exogenous Lipoid Pneumonia Following Ingestion of Large Dose Squalene : Successful Treatment with Steroid
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 60(2): 235-238.

Published online: 28 February 2006

DOI: https://doi.org/10.4046/trd.2006.60.2.235

Severe Exogenous Lipoid Pneumonia Following Ingestion of Large Dose Squalene : Successful Treatment with Steroid

Hyo Sun Choi, M.D., Hyon Joo Kwag, M.D.1, Seoung Wan Chae, M.D.2, Si Young Lim, M.D., Seong Yong Lim, M.D.

Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

1Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

2Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Address for correspondence: Seong Yong Lim, M.D. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-dong, Jongno-ku, Seoul 110-746, Korea. Phone: (822)2001-2491, Fax: (822)2001-2049, mdlimsy@skku.edu

Received 25 November 2005       Accepted 23 January 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Exogenous lipoid pneumonia (ELP) is an uncommon condition resulting from aspiration or inhalation of vegetable, animal or mineral oil. It results in foreign body type inflammatory reaction of the lung and can show various clinical presentations from asymptomatic incidental finding to severe pneumonia leading to acute respiratory failure. Although many cases have been reported, severe ELP requiring steroid or whole lung lavage for treatment is rare.
We report a case of 51-year old man with esophageal cancer who developed severe ELP following ingestion of large dose shark oil (Squalene) and successfully treated with prednisolone.

Keywords: Lipoid pneumonia, Squalene, Steroid

Figures and Tables

Figure 1
(A) On admission, chest radiograph shows diffuse bilateral ground-glass shadowing, especially over the middle and lower lung fields. (B) Chest radiograph shows almost complete resolution of both lung lesion after steroid therapy
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Figure 2
High resolution computed tomographic scan of the chest demonstrates extensive bilateral ground-glass opacity in both lower lobe, right middle lobe and left lingular segment.
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Figure 3
Bronchoalveolar lavage fluid obtained by bronchoscopy shows yellowish lipid layer on the surface.
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Figure 4
Light microscopic finding from BAL shows numerous red staining positive fat materials (Oil Red O stain, ×400).
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