1 Introduction
Lipoid pneumonia(LP) is a rare disease caused by inhalation or
aspiration of oily substances and has been reported with an incidence of
only 1%~2.5% in autopsy series.1Based on the source of the lipid, LP is categorized as follows:
Exogenous lipoid pneumonia(ELP), due to an episode of aspiration of a
large quantity of a oil-based product; endogenous LP, related to
uncommon medical conditions.2,3 Historically, Laughlen
reported the first cases of exogenous lipoid pneumonia in one adult and
in four children after chronic exposure to mineral oil nose drops and
laxatives.4 Since then, most cases have been reported
in patients with a predisposition to aspiration, such as mental
retardation, cleft palate, anatomic or functional abnormality in
swallowing.4-8 But, there have been some reports of
exogenous LP caused by traditional folk remedies.9Various causative agents can cause LP, depending on local life style and
cultural differences among patients.3,10,11 In China,
kerosene, as a special kind of mineral oil for worship, has been
reported as a common cause of exogenous LP.3,10
Due to lack of specific radiological features and manifestations of LP
and awareness about this disease, diagnosis can be missed or delayed at
the right time, which may lead to progress and unnecessary
therapy.2,12 The nature history and outcome of LP are
greatly variable mainly depending on the type, quantity, chemical
properties and distribution of inhaled materials and are related to
pulmonary tissue injury degree.13 At present , the
treatment strategy for LP is not well defined in the literature and
guildlines, but there is a concensus that the main measure is primarily
supportive and generally conservative, and cease to exposure to the
lipid substances. In 2020, a systematic review indicated that
therapeutic lung lavage might be effective and safe treatment with
long-term benefits for exogenous LP.12 In children
patients with diffuse pulmonary lesion, aggressive therapy has been
reported.7 However, therapy measures about the LP
derives largely from case reports and case series, not long-term
observational studies.12 In this study, we evaluated
the radiological and clinical features of children LP patients used by
therapeutic segmental bronchoalveolar lavage in combination with
prednisolone.