An 18-year-old woman who worked as a hostess at a rural Pennsylvania restaurant decided to try electronic cigarettes, perhaps another of the countless bistro workers who hoped to soothe frayed nerves with smoke, or in this case, a vape.
This hostess, however, paid an unusual price for her use of e-cig, according to a case study published Thursday in the medical journal Pediatrics. As usual in a patient's report, the authors did not disclose the name of the young woman to protect her privacy.
Electronic cigarettes heat the liquid and turn it into vapor, which the user inhales and then exhales into a large swollen cloud. The liquid is known as e-juice and contains flavorings, propylene glycol, glycerin and, often, nicotine, although many users are unaware of this last addictive ingredient.
The hostess had been vaping for about three weeks last year when she developed symptoms bad enough to send her to the emergency room at the University of Pittsburgh Medical Center.
There, the doctors recorded their problems: coughing, shortness of breath that worsened by minute and sudden sharp pains in the chest with each inhalation and exhalation. Not yet feverish, he did not show upper respiratory symptoms, such as nasal discharge or nasal congestion. In the past, he said, the only pulmonary problems he had were mild asthma, which rarely required the use of an inhaler.
When her cough became more frequent, emergency doctors admitted her to the pediatric intensive care unit and began antibiotics. But his condition quickly worsened.
Soon, the young woman experienced what is commonly known as respiratory failure, said Dr. Daniel Weiner, one of the patient's doctors, co-author of the new report and medical director of the Children's Hospital. of Pittsburgh in UPMC.
"He could not get enough oxygen from the lungs in his blood and needed a mechanical respirator (respirator) to breathe until his lungs recovered," Weiner said.
The hostess not only needed a respirator, she needed tubes inserted on both sides of her chest to drain the fluid from her lungs.
His doctors diagnosed hypersensitivity pneumonitis, sometimes called wet lung, an inflammation of the lungs due to an allergic reaction to chemicals or dust.
Dr. Casey Sommerfeld, the patient's pediatrician and lead author of the study, said the chemicals in the electronic cigarettes caused lung damage and inflammation, prompting the woman's body to elicit an immune response.
"This immune response can cause an increase in inflammation and the presence of" leaking "blood vessels, which can lead to fluid buildup in the lungs," said Sommerfeld, now Children's general pediatrician. Healthcare of Atlanta.
More case reports and side effects & # 39;
The woman was treated with an intravenous methylprednisolone, a medication used to treat severe allergic reactions.
She improved rapidly and was disconnected from the mechanical support system five days after being admitted to the hospital.
"It is difficult to speculate on the frequency with which this could happen, however, there are some case reports involving adults who developed respiratory distress after the use of the electronic cigarette," Sommerfeld said. "As the use of electronic cigarettes increases, we will see more case reports and side effects."
Ilona Jaspers, professor in the departments of pediatrics and microbiology and immunology at the University of North Carolina at Chapel Hill, said the case study suggests that electronic cigarettes will cause negative health consequences that had not been seen with the conventional cigarettes.
Jaspers, who was not involved in the study, added that although he describes only one patient, "he highlights the importance of possible adverse effects." health effects associated with the use of electronic cigarettes. "
In addition, the diagnosis of symptoms related to a series of severe pulmonary conditions suggests that the negative health effects of electronic cigarettes may" manifest themselves in different ways ", He said.
His research has shown that certain e-cigarettes cigarette flavor chemicals significantly reduce the function of immune cells.
& # 39; Risk-taking behavior & # 39;  Sommerfeld noted that since vaping products contain nicotine, "vaping can cause side effects such as dizziness, headaches, nausea, heart racing, anxiety and difficulty sleeping." It is known to be addictive and children can get hooked on electronic cigarettes ".
Jaspers said that, "in addition to nicotine addiction, which itself will have effects on the adolescent brain, we still do not know what the long-term health effects of exposure to electronic cigarettes may be. to know if the potential health effects caused by the use of electronic cigarettes are more pronounced "in adolescents.
The rapid spread of vaping was highlighted by a 2016 report from the US Surgeon General. UU which cited a 900% increase in the use of electronic cigarettes by high school students from 2011 to 2015. Meanwhile, the 2016 National Youth Survey on Tobacco observed that 1.7 million high school students reported using electronic cigarettes in the last 30 days.
"I hope we can find a way to reverse this rapidly trend," said Jaspers.
Sommerfeld agreed. The use of electronic cigarettes "normalizes" smoking, he said, and is related to a "greater likelihood of using cigarettes or typical tobacco products." For this reason, vaping and the use of electronic cigarettes should be included in discussions about "risky behavior" with adolescents, he said.
"As a pediatrician, I am always an advocate for children and I try to speak for the best interest of children."