Exogenous lipoid pneumonia secondary to repetitive micro-aspiration of paraffin oils laxatives

Lipoid pneumonia (LP) is a rare lung disease caused by the exposure and subsequent accumulation of lipidic substances in the lung. It can be classified in exogenous or endogenous and in acute and chronic. A 42-year-old asymptomatic Cau- casian female sought medical attention for incidental detection of bilateral ground glass opacifications at chest CT scan. Bronchoscopy with bronchoalveolar lavage and transbronchial biopsies revealed multifocal amorphous eosinophilic bi- refringent material and lipid laden foamy alveolar macrophages with multivacuolated cytoplasm, stuffed with Oil Red O positive lipid material, strongly suspected for paraffin. A diagnosis of chronic exogenous LP was confirmed when the patient admitted a chronic abuse of paraffin oils as laxatives in the context of an anorexic disorder. We here describe the case of a young woman with an exogenous LP caused by the abuse of paraffin oil laxatives secondary to an eating disor- der. In the last 15 years, 46 cases of acute and chronic exogenous LP have been described. Chronic LP secondary to abuse of oily substances as laxatives in eating disorders were previously described only in two patients. The discontinuation of the causative lipidic agent is the key treatment of the disease.