ABSTRACT Organic solvents contained in oil and waterproofing sprays, along with glycerin and propylene glycol found in e‐cigarettes, have been reported to trigger exogenous lipoid pneumonia. We report a 30‐year‐old male who developed lipoid pneumonia following exposure to paraffin‐based oil spray, waterproofing spray, and subsequent e‐cigarette use. Initial evaluation suggested occupational asthma due to elevated IgE and fractional exhaled nitric oxide levels, but inhaled corticosteroid therapy was ineffective. Chest computed tomography eventually revealed diffuse ground‐glass opacities, and bronchoalveolar lavage fluid analysis demonstrated lipid‐laden macrophages, confirming the diagnosis. Component analysis indicated that e‐cigarette vapor containing glycerin and propylene glycol was the primary trigger, whereas occupational exposures contributed minimally. The patient was managed with observation without steroid therapy, and symptoms resolved over 4 months with lifestyle modifications, including cessation of e‐cigarette use. This case highlights the combined impact of occupational and lifestyle factors in exogenous lipoid pneumonia and emphasizes the importance of assessing inhaled substances, workplace environment, and e‐cigarette use to determine the cause and guide exposure control.
Wakamatsu et al. (Wed,) studied this question.