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Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa
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 Cros...
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| Other Authors: | |
| Format: | Thesis |
| Language: | English |
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Department of Paediatrics and Child Health
2019
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| _version_ | 1867613149298950144 |
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| access_status_str | Open Access |
| author | Marangu, Diana Mwendwa |
| author2 | Zampoli, Marco |
| author_browse | Marangu, Diana Mwendwa Zampoli, Marco |
| author_facet | Zampoli, Marco Marangu, Diana Mwendwa |
| author_sort | Marangu, Diana Mwendwa |
| collection | Thesis |
| description | 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/29819 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:31:31.816Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2019 |
| publishDateRange | 2019 |
| publishDateSort | 2019 |
| publisher | Department of Paediatrics and Child Health |
| publisherStr | Department of Paediatrics and Child Health |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/29819 Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa Marangu, Diana Mwendwa Zampoli, Marco Gray, Diane Vanker, Aneesa Paediatric Pulmonology 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. 2019-02-27T11:22:34Z 2019-02-27T11:22:34Z 2018 2019-02-25T12:35:49Z Master Thesis Masters MPhil http://hdl.handle.net/11427/29819 eng application/pdf Department of Paediatrics and Child Health Faculty of Health Sciences University of Cape Town |
| spellingShingle | Paediatric Pulmonology Marangu, Diana Mwendwa Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa |
| thesis_degree_str | Master's |
| title | Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa |
| title_full | Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa |
| title_fullStr | Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa |
| title_full_unstemmed | Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa |
| title_short | Exogenous Lipoid Pneumonia in Children: A Systematic Review and Case Series from South Africa |
| title_sort | exogenous lipoid pneumonia in children a systematic review and case series from south africa |
| topic | Paediatric Pulmonology |
| url | http://hdl.handle.net/11427/29819 |
| work_keys_str_mv | AT marangudianamwendwa exogenouslipoidpneumoniainchildrenasystematicreviewandcaseseriesfromsouthafrica |