CHEST Guidelines-A-48-Year-Old-Amateur-Bodybuilder-With-History-of-

A-48-Year-Old-Amateur-Bodybuilder-With-History-of-

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The document presents a medical case involving a 48-year-old amateur bodybuilder who experienced progressive shortness of breath and other symptoms, including chest pain and lower extremity edema, over six months. He had a significant history of anabolic steroid use and was injecting mineral oil into his muscles for cosmetic enhancement, which led to exogenous lipoid pneumonia. This condition arises from the inhalation or aspiration of oils, leading to pulmonary dysfunction. <br /><br />Upon examination, the patient appeared drowsy and had an irregular heartbeat and breathing patterns. Diagnostic imaging and tests, including CT scans and a lung biopsy, revealed abnormalities consistent with lipoid pneumonia, such as lipid-laden macrophages and ground glass opacities with fat attenuation. The patient had severe pulmonary hypertension and cor pulmonale, likely contributing to his respiratory failure.<br /><br />Exogenous lipoid pneumonia often presents as nonspecific respiratory symptoms, can mimic other lung diseases, and may require an extensive diagnostic process. It is typically diagnosed through a combination of patient history, imaging, and histologic findings. The disease process is exacerbated when the offending substance, in this case, mineral oil, is not identified and discontinued immediately.<br /><br />Treatment primarily involves cessation of the oil exposure and supportive care, although corticosteroids may be considered for severe inflammation. In some cases, whole lung lavage can be helpful. Unfortunately, despite treatment efforts and initial improvement, the patient suffered a cardiopulmonary arrest before follow-up.<br /><br />This case highlights the significance of thorough patient history and evaluation when encountering pulmonary symptoms possibly related to exogenous substances. Proper intervention and management require identifying and avoiding the causative agent to prevent further complications.

Keywords

exogenous lipoid pneumonia

anabolic steroid use

mineral oil injection

pulmonary dysfunction

ground glass opacities

pulmonary hypertension

cor pulmonale

respiratory failure

corticosteroids treatment

cardiopulmonary arrest