Exogenous lipoid pneumonia in children: A systematic review

Area of Science:

• Pediatric Pulmonology
• Radiology
• Pathology

Background:

• Exogenous lipoid pneumonia (ELP) in children is rare but documented globally.
• Often associated with cultural or medical practices involving oil aspiration.
• Clinical presentation and radiological findings can be diverse.

Purpose of the Study:

• To comprehensively describe the clinical, radiological, and pathological features of pediatric ELP.
• To evaluate treatment outcomes for children diagnosed with ELP.
• To identify diagnostic challenges and potential co-infections.

Main Methods:

• Systematic review of studies published between 1967 and 2018.
• Inclusion of non-accidental cases of ELP in pediatric patients.
• Analysis of clinical presentation, diagnostic methods, and treatment strategies.

Main Results:

• 44 studies involving 489 children (1 day to 17 years) were analyzed.
• High diagnostic certainty achieved with bronchoalveolar lavage and lung biopsy confirming extracellular lipid.
• Non-tuberculous mycobacterial infections (e.g., Mycobacterium fortuitum) were noted in some cases.
• Treatments included supportive care, corticosteroids, oil cessation, lung lavage, and surgery.
• Treatment outcomes were inconsistently reported across studies.

Conclusions:

• Pediatric ELP persists globally due to cultural and medical practices.
• There is a lack of standardized reporting and studies on treatment efficacy.
• Preventive strategies and improved diagnostic/treatment protocols are needed.