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Vaping-associated lung injury
  1. Orla O'Carroll1,2,
  2. Keshav Sharma3,
  3. Aurelie Fabre4,
  4. David J Murphy5,
  5. Michael P Keane1,2,
  6. Cormac McCarthy1,2
  1. 1Respiratory Medicine, St. Vincent's University Hospital, Dublin, Ireland
  2. 2School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
  3. 3Department of Medicine, Wexford General Hospital, Wexford, Ireland
  4. 4Histopathology, St. Vincent's University Hospital, Dublin, Ireland
  5. 5Radiology, St. Vincent's University Hospital, Dublin, Ireland
  1. Correspondence to Dr Cormac McCarthy, Medicine, University College Dublin, Dublin 4, Ireland; cormac.mccarthy{at}

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An 18-year-old man presented to the emergency department of a community hospital with a cough, fever, night sweats and significant weight loss. He recently completed an antibiotic course for a lower respiratory-tract infection. Full blood count revealed a normal total white cell count with eosinophil count of 0.85×109/L. C-reactive protein (CRP) was normal but erythrocyte sedimentation rate (ESR) was 100 mm/hour. Chest radiograph demonstrated bilateral perihilar reticulonodular opacification with peripheral sparing (figure 1A). Immunoglobulin E was mildly elevated at 175UI/mL; other immunoglobulin levels, viral and autoantibody panels were normal. High-resolution CT thorax revealed diffuse centrilobular and peribronchovascular ground-glass opacification throughout both lungs with subpleural sparing (figure 1B/C). On further questioning, the patient disclosed a history of extensive vaping in the preceding 6 months including nicotine and tetrahydrocannabinol-containing products. He was referred to a specialist …

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