Exogenous Lipoid Pneumonia Induced by the Excessive Use of Menthol-containing Nasal Inhalers and Subsequent Acute Hypersensitivity Pneumonia Triggered by Domestic Environmental Antigens: A Case Report.

IF 1.1

Internal medicine (Tokyo, Japan) Pub Date : 2025-06-05 DOI:10.2169/internalmedicine.5358-25

Yuki Fukushiro, Yasushi Horimasu, Kakuhiro Yamaguchi, Shinjiro Sakamoto, Takeshi Masuda, Taku Nakashima, Hiroshi Iwamoto, Shinichiro Ohshimo, Kazunori Fujitaka, Noboru Hattori

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Abstract

A 58-year-old Japanese man presented at our hospital with respiratory failure. Computed tomography (CT) revealed scattered fat-attenuated consolidations, and bronchoalveolar lavage fluid (BALF) showed neutrophilia, leading to a diagnosis of exogenous lipoid pneumonia (ELP) caused by the excessive use of a menthol-containing nasal inhaler. Despite a temporary improvement, the patient experienced recurrent respiratory failure shortly after discharge. Computed tomography (CT) revealed centrilobular ground-glass opacities, and a bronchoalveolar BALF analysis revealed lymphocytosis, suggesting acute hypersensitivity pneumonitis (AHP) triggered by domestic environmental antigens. Antigen avoidance was successful and remission was maintained. The rare sequential occurrence of AHP following ELP suggests a potential pathophysiological connection between these conditions.

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过量使用含薄荷醇鼻吸入器致外源性脂质肺炎及国内环境抗原诱发急性超敏性肺炎1例

一名58岁日本男性因呼吸衰竭来我院就诊。计算机断层扫描（CT）显示分散的脂肪减弱实变，支气管肺泡灌洗液（BALF）显示中性粒细胞增多，导致诊断外源性脂质肺炎（ELP），由过量使用含薄荷醇的鼻吸入器引起。尽管有暂时的改善，病人出院后不久又出现了反复的呼吸衰竭。计算机断层扫描（CT）显示小叶中心毛玻璃影，支气管肺泡BALF分析显示淋巴细胞增多，提示由国内环境抗原引发的急性超敏性肺炎（AHP）。抗原避免是成功的，并维持缓解。在ELP之后发生AHP的罕见顺序提示这些情况之间存在潜在的病理生理联系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Internal medicine (Tokyo, Japan)

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