{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T02:53:57Z","timestamp":1784170437081,"version":"3.55.0"},"reference-count":12,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,3,29]]},"published-print":{"date-parts":[[2022,4]]},"abstract":"<jats:p>We present a case of a woman who had progressive shortness of breath and wheezing with a mild restrictive pulmonary function pattern. She was initially diagnosed with eosinophilic granulomatosis with polyangiitis on the basis of peripheral eosinophilia, bronchoalveolar lavage eosinophilia (47%) and surgical lung biopsy findings. Six months following her diagnosis, the patient returned because of persistent symptoms, and a second review of the lung biopsy revealed thrombotic lesions in the pulmonary vessels with polarisable foreign body materials, associated giant cell reactions and numerous eosinophil infiltrates, consistent with intravenous drug abuse. Further investigation showed that she had a history of intravenous heroin overdose, and the diagnosis of excipient lung disease was made. This case highlights the importance of expert pathological, radiological and clinical review of complex presentations and the need for a thorough medication and drug use history review.<\/jats:p>","DOI":"10.1136\/bcr-2021-247763","type":"journal-article","created":{"date-parts":[[2022,5,23]],"date-time":"2022-05-23T11:28:14Z","timestamp":1653305294000},"page":"e247763","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Excipient lung disease secondary to intravenous heroin use"],"prefix":"10.1136","volume":"15","author":[{"given":"Gretchen A","family":"Colbenson","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aahd","family":"Kubbara","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian W","family":"Cox","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunhee S","family":"Yi","sequence":"additional","affiliation":[{"name":"Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misbah","family":"Baqir","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"key":"2025082802411258000_15.4.e247763.1","doi-asserted-by":"crossref","first-page":"154","DOI":"10.5578\/tt.10438","article-title":"Acute eosinophilic pneumonia secondary to heroin inhalation","volume":"65","author":"Ey\u00fcpo\u011flu","year":"2017","journal-title":"Tuberk Toraks"},{"key":"2025082802411258000_15.4.e247763.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjms.2017.03.020"},{"key":"2025082802411258000_15.4.e247763.3","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1183\/09031936.93.06050750","article-title":"Acute eosinophilic pneumonia in a heroin smoker","volume":"6","author":"Brander","year":"1993","journal-title":"Eur Respir J"},{"key":"2025082802411258000_15.4.e247763.4","doi-asserted-by":"publisher","DOI":"10.1148\/rg.273065051"},{"key":"2025082802411258000_15.4.e247763.5","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.cdip.2004.04.009","article-title":"The pulmonary pathology of illicit drug and substance abuse","volume":"10","author":"Tomashefski","year":"2004","journal-title":"Curr Diagn Pathol"},{"key":"2025082802411258000_15.4.e247763.6","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(76)90508-8"},{"key":"2025082802411258000_15.4.e247763.7","doi-asserted-by":"crossref","first-page":"1003","DOI":"10.1148\/rg.2020190180","article-title":"Noninfectious granulomatous diseases of the chest","volume":"40","author":"Naeem","year":"2020","journal-title":"Radiographics"},{"key":"2025082802411258000_15.4.e247763.8","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.96.09010175"},{"key":"2025082802411258000_15.4.e247763.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-008-0938-0"},{"key":"2025082802411258000_15.4.e247763.10","doi-asserted-by":"publisher","DOI":"10.1097\/01.rti.0000213567.86408.19"},{"key":"2025082802411258000_15.4.e247763.11","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.14.12582"},{"key":"2025082802411258000_15.4.e247763.12","doi-asserted-by":"crossref","first-page":"454","DOI":"10.3349\/ymj.2019.60.5.454","article-title":"Comparison of radiological and histological findings of lung parenchyma in patients with antineutrophil cytoplasmic antibody-associated vasculitis","volume":"60","author":"Park","year":"2019","journal-title":"Yonsei Med J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2021-247763","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:41:16Z","timestamp":1756374076000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2021-247763"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,4,21]]},"published-print":{"date-parts":[[2022,4]]}},"alternative-id":["10.1136\/bcr-2021-247763"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2021-247763","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,4]]}}}