상어간유 흡입에 의한 지방성 폐렴 1례
A Case of Lipoid Pneumonia Induced by Aspiration of Shark Liver Oil
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초록
소아에서는 반사적인 방어 기전의 미숙으로 우유나 간유 등 지방성 물질이 흡입되기 쉬워서 건강한 소아에서도 발생할 수 있다. 따라서 본 증례에서와 같이 검사 상 다른 특징적인 이상이 없고, 항생제에 반응을 하지 않는 경우에는 지연성 호전을 보이는 폐렴에 대해서 고려해 보아야 하고, 그 중 지방성 폐렴의 경우에는 검사보다 병력 청취가 더 중요하다는 것을 보여준다. 저자들은 기침과 2주간 지속되는 발열을 주소로 입원한 평소 건강하던 환아에서 스쿠알렌 복용에 의한 지방성 폐렴 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Lipoid pneumonia, a rare disease entity, results from accumulation of lipids in the alveoli. It results from the aspiration of vegetable, animal oil or mineral oil. Squalene is a derivative of shark liver oil that is taken as a traditional remedy in some Asian counties and is used widely also in cosmetics. Although many cases with predisposing factors have been reported, lipoid pneumonia can occur in normal individuals without predisposing factors. A 2-year-old boy was admitted to the hospital with a history of fever and cough for during 2 weeks. On physical examination, his lung sound was decreased in the right lung field. He was found to have infiltrate in the right upper lobe, middle and lower lung field on a chest radiograph. His parents fed him with squalene. High resolution computed tomography scan of the chest showed `Crazy-paving appearance` in the right upper, middle and lower lobes. Lipoid pneumonia is suggested when there is a history of oil- or lipid- based product use or consumption. The characteristic finding of lipid materials, 'Crazy-paving appearance' in chest Computed Tomography (CT) or chest Magnetic Resonance Image (MRI), may be useful in the diagnosis of lipoid pneumonia. We report the case of lipoid pneumonia of a 2-year-old healthy child with a history of squalene.
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