Hemoptysis following e-cigarette inhalation: A toxicological concern in vaping-related lung injury

Introduction: Electronic cigarettes were developed in 2003 with the aim of providing a safer alternative for nicotine consumption and reducing the harms associated with conventional cigarette smoking. The diagnostic criteria for E-cigarette or vaping product use-associated lung injury include: onset of symptoms within 90 days of electronic cigarette use, radiological evidence of pulmonary infiltrates, absence of an underlying infectious cause, and exclusion of alternative causes of respiratory failure. Case Report. A 35-year-old male patient presented to the emergency department with a complaint of massive hemoptysis following heavy electronic cigarettes use. Flexible bronchoscopy was performed, and the bleeding was successfully controlled. However, the patient was readmitted after discharge due to recurrent massive hemoptysis. This time, bronchial artery embolization was performed, resulting in effective control of the symptoms. Discussion: In terms of treatment, aside from corticosteroid therapy, management is generally supportive and includes oxygen supplementation. The purpose of presenting this case is to highlight a rare clinical manifestation of E-cigarette or Vaping product use-Associated Lung Injury, distinct from the commonly reported presentations. Specifically, we report a patient who presented with two separate episodes of massive hemoptysis, a presentation that has been rarely documented in the literature. In the first episode, the bleeding was controlled with flexible bronchoscopy, while in the second episode, bronchial artery embolization was required. To the best of our knowledge, no other case with recurrent massive hemoptysis associated with E-cigarette or vaping product use-associated lung injury has been reported in the literature to date.