TY - JOUR T1 - Diffuse Alveolar Hemorrhage: a life-threatening adverse effect of vaping JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.congress-2020.1871 VL - 56 IS - suppl 64 SP - 1871 AU - Dominika Ambrożej AU - Teresa Bielecka AU - Wojciech Feleszko AU - Katarzyna Krenke Y1 - 2020/09/07 UR - http://erj.ersjournals.com/content/56/suppl_64/1871.abstract N2 - Case description: A 17-year-old boy was referred to the pediatric respiratory department with a history of recurrent epistaxis and hemoptysis of unknown origin. In the last 15 months he had been consulted many times in the emergency department of regional hospital. Despite of a diagnostic full work-up, the cause of epistaxis and hemoptysis could not be established. During the last episode he was admitted to the hospital in poor clinical condition with dyspnea, massive hemoptysis, and severe anemia (Hb <6.5 g/dl).The chest CT revealed both sided ground glass opacities and consolidations (mainly in the right lung) suggesting diffuse alveolar hemorrhage (DAH). Bronchoalveolar lavage showed >90% of haemosiderin-laden macrophages. In the course of a detailed differential diagnosis hematologic, infectious, autoimmune and oncologic causes of DAH were excluded. An in-depth medical history has shown that every single episode of the haemorrhage had been preceded by periods of very intensive vaping. After cessation of vaping, a clinical improvement was noticed and the bleedings did not recur.Discussion: Vaping-associated lung injury (VALI) is a group of rare conditions that may present as an acute eosinophilic pneumonia, lipoid pneumonia, respiratory-bronchiolitis interstitial lung disease and DAH. To our knowledge DAH is one of the most unique form of VALI, with only several case reports published to date. Here, we present a new case highlighting a causative relationship between vaping and DAH – a life-threatening adverse effect.Conclusion: In the light of increasing use of vaporizers, especially among young people, vaping-related DAH should be taken into consideration in the differential diagnosis of pulmonary hemorrhage.FootnotesCite this article as: European Respiratory Journal 2020; 56: Suppl. 64, 1871.This abstract was presented at the 2020 ERS International Congress, in session “Respiratory viruses in the "pre COVID-19" era”.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -