Bronchoalveolar Lavage in Liquid Paraffin Pneumonitis: Discussion (3)

Bronchoalveolar Lavage in Liquid Paraffin Pneumonitis: Discussion (3)Cytologic examination of the sputum for paraffin-laden macrophages and gas chromatography of the sputum after lipid extraction have been proposed for a noninvasive diagnosis of paraffin pneumonitis. However, positive sputa are not constantly found because expectoration of lipoid material may be sporadic or intermitten. buy prednisone
Most of the recently reported cases of mineral oil pneumonitis have been due to liquid paraffin taken by mouth as laxative. In the past, liquid paraffin formed the base of nose drops and throat sprays, but is now rarely used for this purpose. Chronic aspiration of mineral oil is facilitated by deglutition abnormalities; central nervous system diseases such as stroke, Parkinson disease, systemic sclerosis; or esophageal diseases, such as gastroesophageal reflux, achalasia, and megaesophagus, and diverticula. Mineral oil pneumonitis also occurs in aged, debilitated or bedridden patients with central nervous or gut disorders. In such patients, mineral oil is often used at bedtime as laxative: reflux and chronic aspiration are facilitated by decubitus and decreased vigilance during sleep. Quinn and Meyer demonstrated that iodized oil introduced into the nostril of sleeping patients easily and silently entered the bronchial tree without exciting reflex inhibition. Large amounts of oil were found in the dependent regions of the lung by chest roentgenograms the next morning.