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What Is Lipoid Pneumonia?

Medically Reviewed by Dan Brennan, MD on May 11, 2021

Lipoid pneumonia is a rare condition that happens when fat, or lipids, gather in the lungs.

What Is Lipoid Pneumonia?

Lipoid pneumonia, also called lipid pneumonia, is a rare lung disease caused by fat collection in the lungs. This causes inflammation, making the air sacs called alveoli fill up with fluid and pus.

There are two types of lipoid pneumonia: endogenous and exogenous.

Endogenous lipoid pneumonia. This type is sometimes called cholesterol pneumonia or idiopathic pneumonia. It is a reaction to damaged tissue that releases fat and cholesterol. Sometimes that fat and cholesterol can gather in the lungs and cause inflammation and pneumonia. It is usually a chronic condition.

Exogenous lipoid pneumonia. This type is caused by breathing in fatty or oil substances like vegetable oil or mineral oil. The oil particles gather in the lungs and cause pneumonia. Exogenous lipoid pneumonia can be acute, or sudden and severe, or long-term with ongoing exposure to oil substances.

Lipoid Pneumonia Symptoms

Lipoid pneumonia looks different from person to person. The symptoms are often vague and look like other diseases, so it sometimes isn’t diagnosed right away.

Common symptoms of lipoid pneumonia include:

Symptoms can get worse over time or come on suddenly. Animal fats cause more severe reactions than vegetable and mineral oils. Depending on the lung damage, lipoid pneumonia can be severe and life-threatening.

Causes of Endogenous Lipoid Pneumonia

Endogenous lipoid pneumonia is related to other health problems. These are usually fat storage and fat metabolism diseases where your body stores too much fat or has trouble breaking it down. This can cause unusual fat storage in the lungs, which damages tissues and causes inflammation.

These diseases include:

  • Gaucher disease
  • Niemann-Pick disease
  • Fabry disease
  • Farber’s disease
  • Gangliosidosis
  • Krabbe disease
  • Metachromatic leukodystrophy
  • Wolman’s disorder

Lung tumors might also be a cause. The tumor blocks airways and causes cell damage and breakdown. This debris can have cholesterol that builds up and causes inflammation.

Ongoing inflammation from some diseases can also cause lipoid pneumonia, including:

  • Immune system diseases
  • Joint and muscle diseases
  • Pulmonary alveolar proteinosis
  • Chronic lung infection

Causes of Exogenous Lipoid Pneumonia

Exogenous lipoid pneumonia is caused by inhaling oily substances. Your body sees these substances as foreign objects and reacts to extended exposure or contact. There are several common causes.

Vaping. E-cigarette cartridges heat oil, nicotine, or cannabis compounds, flavorings, and other chemicals with an element, which makes a vapor.

When you vape, you inhale these chemicals and tiny oil particles into your lungs. These fatty oil particles gather and cause damage, which leads to acute exogenous lipoid pneumonia.

If you continue to vape, you can get chronic lipoid pneumonia. The more you vape, the more lipid you have in your lungs and the higher chance you have of getting pneumonia.

Laxatives. Taking mineral oil laxatives is the most common cause of lipoid pneumonia. Other oil-based laxatives like cod liver oil, paraffin oil, or glycerine can also lead to pneumonia. Oil-based tablets inserted into the rectum called suppositories can also cause lung problems.

Paints and lubricants. Crude mineral oil is used in manufacturing and other workplaces. People who work with lubricants, machine oil, paints, or pesticides at work or at home can get lipoid pneumonia.

Performers. Fire eaters breathe in petroleum products, which can cause lung problems.

‌Personal care products. Regularly using some personal care products can lead to lipoid pneumonia. Some cases have been caused by:

Oil pulling is the process of swishing sesame oil or coconut oil in the mouth to promote dental health. There have been a few cases of lipoid pneumonia from oil pulling.

Other causes. Suddenly aspirating oily substances into the lungs can cause lipoid pneumonia. Some people are more likely to aspirate, or accidently breathe things into the lungs, including:

  • Children
  • People with a cleft palate
  • People with gastroesophageal reflux disease, or GERD
  • Brain disorders that cause trouble swallowing

Lipoid Pneumonia Treatment

Lipoid pneumonia treatment depends on the cause. If you have endogenous lipid pneumonia, treating the underlying health problem can help. Other treatments might include:

  • Enzyme replacement therapy
  • Whole lung lavage, or washing the lungs with saline solution
  • Steroid medication
  • Oxygen support
  • Respiratory therapy

If you have exogenous lipoid pneumonia, the best treatment is to stop using the substance. This alone is often enough to improve symptoms. There aren’t a lot of other treatments that work.

While lipoid pneumonia is rare, you can avoid it by not vaping and being careful with oily products. Using protective face masks while working around lubricants, paints, pesticides and other airborne products can help prevent lung damage and exogenous lipoid pneumonia.

Show Sources

SOURCES:

American Journal of Roentgenology: “Lipoid Pneumonia: Spectrum of Clinical and Radiologic Manifestations.”

Beck, L. Landsberg, D. Lipoid Pneumonia. StatPearls Publishing, 2021.

BMC Pulmonary Medicine: “Exogenous lipoid pneumonia caused by repeated sesame oil pulling: a report of two cases.”

Johns Hopkins Medicine: “Occupational Lung Diseases.

Journal of General Internal Medicine: “Not Your Typical Pneumonia: A Case of Exogenous Lipoid Pneumonia.

International Journal of Clinical and Experimental Pathology: “Endogenous lipoid pneumonia presenting as solitary pulmonary nodule: a case report.”

NIH National Institute of Neurological Disorders and Stroke: “Lipid Storage Diseases Fact Sheet.”

University of Utah: “Vaping and Pneumonia.”

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