Cosmos Editorial
British doctors have sounded a new warning about e-cigarettes after treating a 16-year-old male for life-threatening respiratory failure they suspect is linked to vaping.
The likely trigger, they say, was an exaggerated immune response to one of the chemicals used in the e-cigarette’s fluid.
The teenager suffered hypersensitivity pneumonitis – a condition in which the air sacs and airways in the lungs become severely inflamed – and it was initially thought this was caused by worsening asthma.
However, he had not been diagnosed with asthma before and, as doctors from Nottingham University Hospitals and others report in the journal Archives of Disease in Childhood, for this to be the very first presentation of asthma “would be virtually unheard of”.
After suffering a fever, cough, and difficulty breathing for a week, the teenager was admitted to hospital, where his condition deteriorated rapidly and he developed respiratory failure, necessitating external assistance for his heart and lungs to work properly. {%recommended 9633%}
Ten days later his condition had become critical, and he developed severe muscle weakness as a result of his critical illness and steroid treatment, which required lengthy rehabilitation.
During his recovery, he revealed that he had recently started vaping, and that he had been doing this fairly frequently, using two different types of e-cigarette liquid. The listed ingredients for both liquids were the same apart from the unnamed flavourings.
He had smoked cannabis, he said, but not for a year. And he had not been in contact with farm animals or birds or recently travelled overseas – factors implicated in allergic respiratory reactions.
He was discharged but was still suffering symptoms two months later. When doctors tested his skin reactivity with a tiny amount of vaping fluid, he got worse, so they took blood samples and analysed both vaping fluids to see if there were any possible chemical triggers.
He seemed to have more antibodies to one of the two liquids, raising the possibility that this might have been the source of his reaction.
After 14 months, his symptoms cleared up, and the condition of his lungs returned to normal.
The doctors stress that this was just one case, and that it’s not clear exactly what the trigger was. But they conclude that there are two important lessons.
“The first is always to consider a reaction to e-cigarettes in someone presenting with an atypical respiratory illness. The second is that we consider e-cigarettes as ‘much safer than tobacco’ at our peril.”
