Tuberc Respir Dis.  2008 Nov;65(5):421-425.

A Case of Exogenous Lipoid Pneumonia after Ingestion of Squalene in Patients with Achalasia

• Park JC
• Jung CY
• Lee JK
• Lee YJ
• Park SC
• Seo HJ
• Kim YJ
• Lee BK
• Huh DM
• Sohn KR

Abstract

Exogenous lipoid pneumonia (ELP) is a chronic inflammatory reaction of the lungs resulting from the aspiration of vegetable, animal or mineral oils. Squalene, is a derivative of shark liver oil that is taken as a traditional remedy in some Asian countries, and is used widely also in cosmetics. Similar to the symptoms in most cases of oil aspiration, the symptoms of squalene-induced lipoid pneumonia are either absent or nonspecific. Hence, the disease is generally detected incidentally. Although many cases with predisposing factors have been reported, ELP with achalasia is quite rare. We report a 47-year old woman with achalasia who developed ELP after ingesting squalene. The patient was treated successfully by supportive care and surgical treatment of the achalasia.

Keyword

Lipoid pneumonia; Achalasia; Squalene

MeSH Terms

Animals
Asian Continental Ancestry Group
Cosmetics
Eating
Esophageal Achalasia
Female
Humans
Liver
Lung
Mineral Oil
Pneumonia
Sharks
Squalene
Vegetables
Cosmetics
Mineral Oil
Squalene

Figure

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  Figure 1 (A) On admission, chest radiography shows ground-glass appearance on right upper and lower lung field. (B) 6 month later, chest radiography shows improvement.

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  Figure 2 High resolution computed tomography scan of the chest shows multifocal GGA and nodule with crazy paving appearance on right upper lobe and esophageal dilatation.

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  Figure 3 (A) Esophagogram shows dilated aperistalitic esophagus and beaklike narrowing near gastroesophageal junction. (B) Esophageal manometry shows incomplete LES relaxation, simultaneous contraction and aperistalsis at distal body.

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  Figure 4 (A) Light microscopic finding from VATs biopsy shows alveolar macrophage with prominent vacuolar change (H&E stain, ×100). (B) Light microscopic finding from VATs biopsy shows numerous red staining fat materials (Oil Red O Stain, ×100).

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