Source: Annual Congress 2002 - Miscellaneous respiratory infections in children
Disease area: Interstitial lung diseases

Abstract

Objective: Various toxic pulmonary side effects of marijuana-abuse are described.
Case report: A 16-year-old boy presenting with exercise intolerated dry cough, fatigue and a diffuse interstitial infiltrate on chest x-ray was referred for further investigation. There was a history of marijuana-abuse (5 joints per day) and nicotine-abuse (2 pack years). All examinations such as laboratory findings, blood gas analysis, Mantoux-test and pulmonary function test were negative. There was no evidence of sarcoidosis or allergic alveolitis, the interstitial pneumopathy remained of unknown origin. The marijuana-abuse was discussed as a possible pathogenetic factor. In the meantime the patient failed to attend clinical control visit, he was again referred 12 months later due to increasing exercise intolerance. CT scans showed persistance of the interstitial infiltrate, a restrictive pattern of functional impairment was noted in lung function testing. A bronchoscopy with bronchoalveolar lavage and transbronchial biopsy was performed which demonstrated a lymphohystiocytic inflammation. A histiocytosis was proven histochemically by positive CD 1 a. The follow-up has shown a stable disease, but there is massive psychic alteration with continuous abuse of marijuana.
Conclusion: Nicotine-abuse as a pathogenetic factor of pulmonary histiocytosis is well described, however we hypothesize that marijuana-abuse is an additional pathogenetic factor for pulmonary histiocytosis.

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Citations should be made in the following way:
K. Scheinemann, P. A. Eng, W. Ruch, M. Solèr, H. E. Gnehm (Aarau, Basel, Switzerland). Pulmonary histiocytosis triggered by marijuana- and nicotine-abuse. Eur Respir J 2002; 20: Suppl. 38, 2102

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