A 17-year-old male who ended up in hospital on life support may represent a new form of illness related to vaping, or e-cigarettes.
In an article published November 20 in the Canadian Medical Association Journal, medical researchers and doctors associated with London, Ontario's Western University, The University of Toronto, the University Health Network, and Toronto's Hospital for Sick Children described the case of an unnamed male teen who was admitted to hospital in Ontario with what appeared to be acute bronchiolitis, an infection that causes inflammation and congestion of the lungs' small airways, or bronchioles.
The teen ended up intubated and on mechanical respiration and with cardiac support, according to the paper, before improving after high doses of corticosteroids. Tests showed no viral cause. He was discharged after 47 days in hospital but several months later still exhibits "persistent, fixed airflow obstruction" and can perform only limited exercise.
Because the patient admitted "intensively" vaping flavoured e-liquids and tetrahydrocannabinol (THC) products, the paper's authors suggested that he suffered from "possible bronchiolitis obliterans, thought to be secondary to inhalation of flavouring agents in the e-liquids."
Bronchiolitis obliterans is a disease that causes bronchiole obstruction due to inflammation that results in scar-tissue formation; the disease has no cure but the damaging effects can be slowed with treatment, which sometimes entails a lung transplant.
The disease is also known as "popcorn lung" because several workers in a U.S. popcorn factory contracted the disease after inhalation exposure to a heated chemical compound called diacetyl, used to give microwave popcorn a buttery flavour. Diacetyl is known to be used as a flavouring compound in e-cigarettes.
The paper's authors concluded: "This novel pattern of pulmonary disease associated with vaping appears distinct from the type of alveolar injury predominantly reported in the recent outbreak of cases of vaping associated pulmonary illness in the United States."
That pulmonary illness, thought to be responsible for dozens of recent deaths and hundreds of hospitalizations in the U.S. and Canada, has been called "e-cigarette, or vaping, product use associated lung injury" (EVALI) by researchers with the U.S.-based Centers for Dusease Control and Prevention.
The B.C. government has announced that it will be introducing restrictions on vaping sales and advertizing in the spring of 2020, as well as a new and much higher tax on the sale of e-cigarette materials and accessories early in the new year.
Finally, the CMAJ article recommends "further research into all potentially toxic components of e-liquids and tighter regulation of e-cigarettes".