Abstract
The development of lipid aspiration pneumonia after chronic nasopharyngeal installation of mineral oil was first described in 1925 by Laughlin. Since that time this entity has been well recognized and numerous substances have been identified or implicated as the aspirated material. The classic radiographic appearance of severe chronic lipid aspiration pneumonia has been described as consisting of intense perihilar infiltrates. However, the radiographic findings are more often non-specific and usually consist of varying degrees of diffuse interstitial infiltrates that tend to be more prominent in the perihilar regions and the right lung. We are reporting a case of biopsy-proven lipid aspiration pneumonia in an infant with known gastro-esophageal reflux (GER) who had medium-chain triglyceride oil administered via nasogastric tube. Serial roentgenograms demonstrated a changing pulmonary pattern from diffuse bilateral interstitial infiltrates initially to a diffuse alveolar pattern at the time of the lung biopsy.
References
Laughlin GF (1925) Studies on pneumonia following nasopharyngeal injections of oil. Am J Pathol 1: 407
Pinkerton H (1927) Oils and fats: their entrance into and fate in the lungs of infants and children: a clinical and pathological report. Am J Dis Child 33: 259
Pierson JW (1932) Some unusual pneumonias associated with the aspiration of fats and oils in the lungs. AJR 27: 572
Bromer RS, Wolman IJ (1939) Lipoid pneumonia in infants and children. Radiology 32: 1
Moran JR, Block SM, Lyerly AD, Brooks LE, Dilard RG (1988) Lipid-laden alveolar macrophage and lactose assay as markers of aspiration in neonates with lung disease. J Pediatr 112: 643
Nussbaum E, Maggi JC, Mathis R, Galant SP (1987) Association of lipid-laden alveolar macrophages and gastroesophageal reflux in children. J Pediatr 110: 190
Corwin RW, Irwin RS (1985) The lipid-laden alveolar macrophage as a marker of aspiration in parenchymal lung disease. Am Rev Respir Dis 132: 576
Staugas R, Martin AJ, Binns G, Steven IM (1985) The significance of fat-filled macrophages in the diagnosis of aspiration associated with gastro-oesophageal reflux. Aust Pediatr J 21: 275
Allen CJ, Newhouse MT (1984) Gastroesophageal reflux and chronic respiratory disease. Am Rev Respir Dis 129: 645
Barish CF, Wu WC, Castell DO (1985) Respiratory complications of gastroesophageal reflux. Arch Intern Med 145: 1882
Nelson HS (1984) Gastroesophageal reflux and pulmonary disease. J Allergy Clin Immunol 73: 547
Berquist WE, Rachelefsky GS, Kadden M, Siegel SC, Katz RM, Fonkalsrud EW, Ament ME (1981) Gastroesophageal reflux-associated recurrent pneumonia and chronic asthma in children. Pediatrics 68: 29
Weissbluth M (1981) Gastroesophageal reflux. Clin Pediatr 20: 7
Brans YW, Andrew DS, Dutton EB, Manchaca EM (1987) Lipids in plasma of enterally-fed low-birthweight neonates. Am J Perinatol 4: 160
Bach AC, Babayan VK (1982) Medium-chain triglycerides: an update. Am J Clin Nutr 36: 950
Smith RM, Brumley GW, Stannard MW (1978) Neonatal pneumonia associated with medium-chain triglyceride feeding supplement. J Pediatr 92: 801
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Wolfson, B.J., Allen, J.L., Panitch, H.B. et al. Lipid aspiration pneumonia due to gastroesophageal reflux. Pediatr Radiol 19, 545–547 (1989). https://doi.org/10.1007/BF02389570
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DOI: https://doi.org/10.1007/BF02389570