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Ultrastructural changes in animal fat associated lipoid pneumonia: report of two cases
G E Armah1, S H Annobil, N A Morad
1Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Ghana.
Abstract:
Traditional or cultural practices in different parts of the world where oils are used continue to produce lipoid pneumonia. We report the ultrastructural findings and observations in animal fat associated lipoid pneumonia from two children following a cultural practice of forced feeding with animal fat (ghee). Clinical findings showed an acute or chronic chest infection which failed to respond to anti-microbial therapy. X-ray and chest CT scan revealed collapse/consolidations of the right middle and left lower lobes. Histology and electron microscopy revealed thickening and destruction of the alveolar septa, filling of alveolar spaces with red blood cells and macrophage which contained both primary and secondary lysosomes. The alveolar walls contained mostly type II pneumocyte with most of them surrounded by thickened basement membranes with only a small portion of their surfaces exposed directly to the alveolar space where it showed numerous microvilli.
Insights
Forced feeding with animal fat (ghee) in a cultural practice caused lipoid pneumonia in children. This condition presented as persistent chest infections unresponsive to antibiotics, with characteristic lung tissue damage observed.
Area of Science:
- Pulmonology
- Pediatric Pathology
- Toxicology
Background:
- Lipoid pneumonia can arise from traditional oil-based practices.
- Animal fat ingestion, particularly ghee, is implicated in certain cultural feeding rituals.
Observation:
- Two children developed lipoid pneumonia following forced feeding with animal fat (ghee).
- Clinical presentation included persistent, non-responsive chest infections.
- Radiological imaging (X-ray, CT scan) showed lobar collapse and consolidation.
Findings:
- Histopathology revealed thickened, destroyed alveolar septa.
- Alveolar spaces were filled with erythrocytes and macrophages containing lysosomes.
- Electron microscopy showed type II pneumocytes with thickened basement membranes and prominent microvilli.
Implications:
- Highlights the risk of lipoid pneumonia from cultural practices involving oil aspiration.
- Underscores the need for awareness among clinicians regarding non-infectious causes of pediatric lung disease.
- Suggests potential mechanisms of lung injury related to lipid deposition and inflammatory responses.