Bronchoalveolar Lavage in Liquid Paraffin Pneumonitis

Bronchoalveolar Lavage in Liquid Paraffin PneumonitisIaughlen first reported in 1925 four cases of lipoid pneumonitis following the use of mineral oil for nose drops or laxatives. Three of his cases occurred in young children and one in an adult with soft palate and vocal cord paralysis. Two years later, Pinkerton2 described six children with lipoid pneumonitis following the use of mineral, animal (cod liver oil) or vegetable (milk fat) oil. Then the number of reported cases increased during the next years. Large series of lipoid pneumonitis mainly due to mineral oil used as laxative or intranasally, or to cod liver oil were reported in adults or children. Then the hazard of oil aspiration was emphasized leading to a decrease in the use of mineral oil for nose drops or as laxative, and to a probable decrease in the incidence of mineral oil pneumonitis.
However, cases reported since 1970 stress the persistence of mineral oil pneumonitis and the delay of diagnosis often made on post mortem study* or at an advanced stage of respiratory failure. An earlier diagnosis in the course of mineral oil pneumonitis is not easy because the history of ingestion of mineral oil is not readily ascertained, the symptoms appear at an advanced stage of the disease, and the biologic, radiologic, and functional features are not specific of the disease. Chemical analysis of lung surgical biopsy specimen or sputum cytology have been proposed for the diagnosis but the finding of lipophages in the sputum is inconsistent, and lung biopsy may be a risked procedure in these often critically ill patients. Buy Asthma Inhalers Online
We report the cytologic and biochemical results of BALF analysis from seven patients with chronic liquid paraffin pneumonitis seen in our department from September 1981 to March 1989. To our knowledge, this is the first report showing that BALF analysis is a useful tool for the diagnosis of liquid paraffin pneumonitis.