Bronchoalveolar Lavage in Liquid Paraffin Pneumonitis: Results (1)

Patient Population with Liquid Paraffin Pneumonitis
The seven nonsmokers (four women and three men) between 56 and 87 years old (mean 69) were hospitalized for chronic pneumonitis (Table 1). None had any known respiratory disease in their past medical history. A neurologic or psychiatric disorder was present in four of them: chronic psychosis treated with neuroleptic (patient 1); severe Parkinson disease treated with levodopa (patient 2) or bromocriptine mesylate (patient 5); and persistent palatal paresis and difficulties for swallowing (patient 3). Patient 6 had a chronic aggressive hepatitis, thyroiditis, and Sjogrens syndrome.
Only one patient complained of marked dyspnea. The others acknowledged slight or no dyspnea in spite of extensive pulmonary disease for patients 1 and 2. All but one patient had frequent cough but were not able to raise any sputum. Most of them had anorexia, asthenia, and were underweight. Chest auscultation found fine crackles rales on posterior and lateral bases. There was no clubbing, but cyanosis was noted in patient 4. Roentgenographic examination revealed bilateral dense alveolointerstitial infiltrates of the inferior, middle lobes and lingula in four patients (Fig 1). The roentgenographic abnormalities were more spread than expected on symptoms. The three other patients had more limited infiltrates to the left lower lobe (patient 3), right middle lobe (patient 5), right middle and lower lobe (patient 7).

Table 1—Clinical Features., Chest X-Ray Findings and Blood Gas Analysis in Patients with Liquid Paraffin Pneumonitis

Patient Sex Age PredisposingFactors Dyspnea Cough Sputum Crackles ChestX-ray

Infiltrate

Pa02, mm Hg PaC02, mm Hg Follow-up Outcome
1 F 56 Chronic psychosis Reflux esophagitis + + + + Diffuse 48 38 7 yr Stable
2 M 73 Parkinson disease + + + + Diffuse 39 47 2 mo Death(Parkinson

disease)

3 F 65 Membranous palate paralysis + 1+ + + + LLL .53 40 4 yr Death(Myocardial

infarction)

4 F 87 Reflux esophagitis -I- -I- + + + + + + Diffuse 36 43 1 mo Death(Intestinal

infarction)

5 M 64 Parkinson disease + 1+ + + + RML 55 38 1 yr Stable
6 F 60 Reflux esophagitis + + + + Diffuse 4 >r Stable
7 M 75 Reflux esophagitis + + + + + + RML, RLL 1 yr Death (cardiac and respiratory failure)

Figure-1

Figure 1. Posterioranterior chest roentgenogram of patient 1 with liquid paraffin pneumonitis.

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