title: Study of Acute Exogenous Lipoid Pneumonia.
abstract: OBJECTIVE
  To analyze the clinical and imagenological characteristics of acute Exogenous lipoid pneumonia (ELP), explore its risk factors, and assess the potential role of multiple bronchoalveolar lavages (BALs) and steroid therapy in the treatment of children with acute ELP.
  
  
  METHODS
  Between May 2011 and July 2014, 33 pediatric patients with pneumonia caused by aspiration of oil-based substances were admitted to the Guangzhou Women and Children's Medical Center, Guangdong, China. Data on the demographics of these patients, as well as that on clinical presentations, imagenological characteristics, history of ingestion, laboratory observations, treatment protocol, response to therapy, BAL findings, and treatment outcomes were collected.
  
  
  RESULTS
  The study group consisted of 23 boys (69.7 %) and 10 girls (30.3 %), with ages ranging from 4 mo to 4 y. They were admitted to the hospital 2 h to 13 d after ingesting the oil-based substance. By the time of admission, most patients presented with respiratory distress and other symptoms, including tachypnea (n = 21), cough (n = 25), mild fever (n = 18), progressive dyspnea (n = 12), and pneumorrhagia (n = 5); six patients received mechanical ventilation because of complicated respiratory distress syndrome. The most common laboratory observations were leukocytosis (25 of 33, 75.8 %), neutrophilia (23 of 33, 69.7 %), and anemia (8 of 33, 24.2 %). Serum biochemical examination showed elevated sedimentation rates (24 of 33, 72.7 %), lactate dehydrogenase levels (18 of 33, 54.5 %), and C-reactive protein levels (17 of 33, 51.5 %). The most common finding on computed tomography (CT) scans was areas of consolidation. Within the follow-up duration of 2 wk to 6 mo, all patients with clinical symptoms of ELP experienced remission, and none died. The CT scans of most of the cases were normal by 1 to 3 mo, except for two patients who showed complete improvement 6 mo after treatment.
  
  
  CONCLUSIONS
  It was found that multiple BALs combined with steroid therapy result in significant improvement of clinical, radiologic, and laboratory parameters in children with acute ELP. Further, some traditional practices may predispose children to ELP, even in the absence of underlying risk factors. Finally, pneumorrhagia and acute respiratory distress syndrome may be the main complications of acute ELP in children.
authors.affiliation: Department of Respiratory Infection, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, China. GenLucn@163.com.
authors.forename: Gen
authors.initials: G
authors.lastname: Lu
authors.affiliation: Department of Respiratory Infection, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, China.
authors.forename: Yaping
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, China.
authors.forename: Li
authors.initials: L
authors.lastname: Huang
authors.affiliation: Department of Respiratory Infection, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, China.
authors.forename: Zhijie
authors.initials: Z
authors.lastname: Tong
authors.affiliation: Department of Respiratory Infection, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Xie
authors.affiliation: Department of Respiratory Infection, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, China.
authors.forename: Jialu
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of Respiratory Infection, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, China.
authors.forename: Peiqiong
authors.initials: P
authors.lastname: Wu
mesh_terms: D018893:Bronchoalveolar Lavage; D002675:Child, Preschool; D002681:China; D003371:Cough; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011017:Pneumonia, Lipid / Q000473:pathology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
keywords: Aspiration; Bronchoalveolar lavage; Children; Computed tomography; Lipoid pneumonia; Outcome
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