Nesrin ÖCAL, Armağan GÜNAL, Yakup ARSLAN, Berat KAÇMAZ, Ali COŞKUN, Bahadır Can KARAN, Deniz DOĞAN, Cantürk TAŞCI, Ergun UÇAR

Vücut Geliştiricide İntramuskuler Synthol Enjeksiyonuna Bağlı Lipoid Pnömoni

Bu makalede kas dolgusu amacıyla sentetik bir yağ türevi olan “Synthol” un tekrarlayan intramuskuler kullanımı nedeniyle gelişen kronik eksojen lipoid pnömoni olgusu sunulmuştur. Göğüs kaslarını büyütmek için Synthol kullanan 40 yaşında erkek hasta, bir yıl içinde ilerleyen nefes darlığı ile birlikte polikliniğimize başvurdu. Toraks tomografisinde interstisyel akciğer hastalığı ile uyumlu retikülasyonlar ve septal kalınlaşmalar izlenmekteydi. Hastaya bronkoskopi yapıldı. Bronkoalveolar lavaj ve transbronşiyal biyopsi (TBB) alındı. TBB'nin histopatolojik incelemesinde, intraalveoler ve interstisyel yağlı makrofajlar, yağ partikülleri etrafındaki dev hücreler ve ekstraselüler yağ partikülleri gözlendi. Örnek “lipoid pnömoni” olarak raporlandı. Bizim bilgimize göre Synthol'un intramusküler kullanımına bağlı ekzojen lipoid pnömonisi şimdiye kadar bildirilmemiştir ve olgumuz literatürdeki ilk olgudur.

Anahtar Kelimeler:

Synthol, Lipoid Pnömoni, Sentetik Yağ, Vücut Geliştirme

Exogenous Lipoid Pneumonia Due To Intramuscular Injection of Synthol in a Bodybuilder

We report a case of chronic exogenous lipoid pneumonia that developed due to recurrent intramuscular use of “Synthol”, a synthetic oil derivative, for muscle filling. 40-year-old man, who had used Synthol to enlarge his pectoral muscles, was admitted to the chest diseases polyclinic with shortness of breath progressing within a year. On computerized tomography of thorax there were reticulations and septal thickenings consistent with interstitial lung disease. The patient underwent bronchoscopy. Bronchoalveolar lavage and transbronchial biopsy (TBB) were performed. In the histopathologic study of TBB, intraalveolar and interstitial fatty macrophages, giant cells around fat particles and extracellular fat particles were observed and the specimen was reported as "lipoid pneumonia". According to our knowledge, exogenous lipoid pneumonia due to intramuscular use of Synthol has not been reported heretofore and this is the first case in the literature.

Keywords:

Bodybuilder, Lipoid Pneumonia, Synthetic Oil, Synthol,

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1. Gondouin A, Manzoni PH, Ranfaing E, et al. Exogenous lipid pneumonia: a retrospective multicentric study of 44 cases in France. Eur Respir J. 1996;9:1463–9.
2. Cherrez Ojeda I, Calderon JC, Guevara J, Cabrera D, Calero E, Cherrez A. Exogenous lipid pneumonia related to long-term use of Vicks VapoRub by an adult patient: a case report. BMC Ear, Nose Throat Disord. 2016;16:11.
3. Betancourt SL, Martinez-Jimenez S, Rossi SE, Truong MT, Carrillo J, Erasmus JJ.Lipoid pneumonia:spectrum of clinical and radiologic manifestations. Am J Roentgenol. 2010;194:103-9.
4. Laughlin GF. Studies of pneumonia following injections of oil. Am J Pathol. 1925;1:407–14.
5. Marchiori E, Zanetti G, Mano CM, Irion KL, Daltro PA, Hochhegger B. Lipoid pneumonia in 53 patients after aspiration of mineral oil: comparison of high-resolution computed tomography findings in adults and children. J Comput Assist Tomogr. 2010; 34(1): 9-12.
6. Rahaghi F, Varasteh A, Memarpour R, Tashtoush B. Teppanyaki/Hibachi Pneumonitis: An Exotic Cause of Exogenous Lipoid Pneumonia. Case Rep Pulmonol. 2016; 2016: 1035601.
7. Hotta T, Tsubata Y, Okimoto T, Hoshino T, Hamaguchi S, Isobe T. Exogenous lipoid pneumonia caused by herbicide inhalation. Respirol Case Rep. 2016;4(5): e00172.
8. Yasui H, Yokomura K, Suda T. A severe case of acute exogenous lipoid pneumonia treated with systemic corticosteroid. Respir Med Case Rep. 2016;17: 64–7.
9. Russell M, Storck A, Ainslie M. Acute respiratory distress following intravenous injection of an oil-steroid solution. Can Respir J. 2011;18(4): 59–61.
10. Fumo G, Ferreli C, Murgia S, Galletti R, Pau M. A serious complication due to liquid silicone injection in the legs for cosmetic purpose. Clin Ter. 2013;164(5):377-9.
11. Gersuny R. Ueber eine subcutyane Prothese. Z Heilk. 1900;30:1–5.
12. Pupka A, Sikora J, Mauricz J, Cios D, Plonek T. The usage of synthol in the body building. Polim Med. 2009;39:63–5.
13. Ghandourah S, Hofer MJ, Kießling A, El-Zayat B, Schofer MD. Painful muscle fibrosis following synthol injections in a bodybuilder: a case report. J Med Case Rep. 2012;6:248.
14. https://www.pneumotox.com/drug/view/1171/synthol