EVALI syndrome in a patient with hypersensitivity pneumonitis

Smoking electronic cigarettes, or vaping, is considered by many to be a safe alternative to smoking tobacco. It was only relatively recently that reports began to appear about the development of lung damage caused by electronic cigarettes ― EVALI syndrome. Currently, the morphological manifestations of this syndrome have not been studied sufficiently due to the small number of cases described in the literature. These facts, as well as the fact that the changes that occur are not specific, and may vary in different patients, make it difficult to diagnose the disease in a timely manner.

We have described a clinical case of death in a patient who has repeatedly received inpatient treatment for interstitial lung disease, who was admitted to the pulmonology department with signs of decompensated respiratory failure after prolonged and intensive use of electronic cigarettes. The autopsy revealed morphological signs and justified the clinical symptoms of chronic hypersensitive pneumonitis in combination with EVALI syndrome.

The article also provides a brief review of the literature on EVALI syndrome and hypersensitive pneumonitis with their diagnostic criteria. Like EVALI, hypersensitive pneumonitis is difficult to recognize and diagnose by doctors, which is often associated with low awareness, as well as the absence of pathognomonic symptoms.