E-cigarette, or Vaping, Associated Lung and Hepatic Injury

E-cigarette usage is an increasing mode of nicotine consumption in the United States since it became commercially available in 2006. The National Youth Tobacco Survey revealed a 3-fold increase in e-cigarette usage between 2011 and 2013 in adolescents without a previous history of smoking (1). As of November 2019, reports from the CDC verified 1479 cases of severe lung illnesses associated with e-cigarettes from 49 states (2). Patients presented with complaints of cough, shortness of breath, fever, chest pain, nausea, and diarrhea. Chest radiographs demonstrated bilateral opacities, whereas computerized tomography (CT) showed diffuse ground-glass opacities. Among the most reported cases, nearly all patients were negative for infectious causes with minimal extrapulmonary involvement, such as, gastrointestinal involvement. Recent studies have shown an association of e-cigarette use and liver damage. Hasan, et al, reported that E-cigarette smoke exposure in mice was associated with increased oxidative stress and hepatocyte apoptosis, and rats exposed to e-cigarette extract had elevated liver enzyme levels (3). We report a teenage boy with e-cigarette-related disease presenting with abdominal pain and elevated liver enzymes. It is our hope that abdominal pain and liver injury, in the context of a history of e-cigarette use, will better support a diagnosis of e-cigarette-induced injury, and minimize delay in treatment