Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa

dc.contributor.advisorZampoli, Marco
dc.contributor.advisorGray, Diane
dc.contributor.advisorVanker, Aneesa
dc.contributor.authorMarangu, Diana Mwendwa
dc.date.accessioned2019-02-27T11:22:34Z
dc.date.available2019-02-27T11:22:34Z
dc.date.issued2018
dc.date.updated2019-02-25T12:35:49Z
dc.description.abstractBackground and objective: To describe the clinical-radiological-pathological characteristics and treatment outcomes of childhood exogenous lipoid pneumonia (ELP) and elucidate oil administration practices. Methods: A retrospective study of children with histologically-confirmed ELP at Red Cross Children’s Hospital, South Africa. Caregivers were interviewed to understand oil administration practices. Results: Twelve children of Zimbabwean heritage aged 2.1-10.8 months were identified between 2012 and 2017. Repeated oral administration of plant-based oil for cultural reasons was reported by 10/11 caregivers. Cough (12/12), tachypnea (11/12), hypoxia (9/12) and diffuse alveolar infiltrates on chest radiography (12/12) were common at presentation. Chest computed tomography revealed ground glass opacification with lower zone predominance (9/9) and interlobular septal thickening (8/9). All bronchoalveolar lavage specimens appeared cloudy/milky, with abundant lipid laden macrophages and extracellular lipid on Oil-Red-O staining and documented polymicrobial (6/12) and Mycobacterium abscessus (2/12) co-infection. Antibiotics, systemic corticosteroids and therapeutic partial lung lavage were interventions in all, 8 and 5 patients respectively. Median time to clinical resolution was 1.1 months IQR (0.5-8.0) with radiological resolution only in 2/12 cases. Conclusions: Paediatric ELP resembles pulmonary alveolar proteinosis. Health workers should explicitly probe for a history of oil administration in children with non-resolving pneumonia and consider the diagnosis of ELP in settings where this is a common practice.
dc.identifier.apacitationMarangu, D. M. (2018). <i>Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health. Retrieved from http://hdl.handle.net/11427/29819en_ZA
dc.identifier.chicagocitationMarangu, Diana Mwendwa. <i>"Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2018. http://hdl.handle.net/11427/29819en_ZA
dc.identifier.citationMarangu, D. 2018. Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Marangu, Diana Mwendwa AB - Background and objective: To describe the clinical-radiological-pathological characteristics and treatment outcomes of childhood exogenous lipoid pneumonia (ELP) and elucidate oil administration practices. Methods: A retrospective study of children with histologically-confirmed ELP at Red Cross Children’s Hospital, South Africa. Caregivers were interviewed to understand oil administration practices. Results: Twelve children of Zimbabwean heritage aged 2.1-10.8 months were identified between 2012 and 2017. Repeated oral administration of plant-based oil for cultural reasons was reported by 10/11 caregivers. Cough (12/12), tachypnea (11/12), hypoxia (9/12) and diffuse alveolar infiltrates on chest radiography (12/12) were common at presentation. Chest computed tomography revealed ground glass opacification with lower zone predominance (9/9) and interlobular septal thickening (8/9). All bronchoalveolar lavage specimens appeared cloudy/milky, with abundant lipid laden macrophages and extracellular lipid on Oil-Red-O staining and documented polymicrobial (6/12) and Mycobacterium abscessus (2/12) co-infection. Antibiotics, systemic corticosteroids and therapeutic partial lung lavage were interventions in all, 8 and 5 patients respectively. Median time to clinical resolution was 1.1 months IQR (0.5-8.0) with radiological resolution only in 2/12 cases. Conclusions: Paediatric ELP resembles pulmonary alveolar proteinosis. Health workers should explicitly probe for a history of oil administration in children with non-resolving pneumonia and consider the diagnosis of ELP in settings where this is a common practice. DA - 2018 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa TI - Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa UR - http://hdl.handle.net/11427/29819 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/29819
dc.identifier.vancouvercitationMarangu DM. Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa. []. University of Cape Town ,Faculty of Health Sciences ,Department of Paediatrics and Child Health, 2018 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/29819en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Paediatrics and Child Health
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherPaediatric Pulmonology
dc.titleExogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPhil
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