{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:58:35Z","timestamp":1753887515170,"version":"3.41.2"},"reference-count":21,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:p>Electronic cigarette or vaping product use\u2013associated lung injury (EVALI) is a disease process that has become prevalent in the United States.1 The Centers for Disease Control and Prevention reported there have been almost 2700 cases of this condition in the United States as of January 14, 2020, with &amp;gt;50% of these patients aged \u226424.2 We present a 13-year-old boy with a history of functional abdominal pain who presented with recurrent episodes of nausea, emesis, periodic fevers, and severe episodic abdominal pain after a 12-month history of significant electronic cigarette use. On admission, he had severe abdominal pain and appeared anxious. A computed tomography scan of the abdomen was unremarkable, but a computed tomography scan of the chest demonstrated both multifocal ground-glass and crazy-paving pulmonary opacities bilaterally, with scattered septal thickening and dependent bibasilar opacities associated with volume loss. Inflammatory markers were significantly elevated, and cell counts were remarkable for leukocytosis and neutrophilia. The patient was ultimately diagnosed with EVALI and treated with intravenous methylprednisolone, resulting in improvement. This is an example of a case of EVALI in an adolescent, in which the presenting symptoms are largely gastrointestinal. It is important to keep EVALI in the differential diagnosis of patients who exhibit gastrointestinal symptoms, have markers of increased systemic inflammation, and endorse a history of vaping or are in the age range of electronic cigarette users. Although obtaining an accurate history of vaping can be challenging in the pediatric population, it is especially critical to do so.<\/jats:p>","DOI":"10.1542\/peds.2019-3834","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T09:25:17Z","timestamp":1609320317000},"source":"Crossref","is-referenced-by-count":6,"title":["A Gut Feeling: Abdominal Symptoms as an Initial Presentation of EVALI"],"prefix":"10.1542","volume":"147","author":[{"given":"Christel","family":"Wekon-Kemeni","sequence":"first","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of North Carolina and North Carolina Children\u2019s Hospital, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prathipa","family":"Santhanam","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of North Carolina and North Carolina Children\u2019s Hospital, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pallav","family":"Halani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of North Carolina and North Carolina Children\u2019s Hospital, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Bradford","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of North Carolina and North Carolina Children\u2019s Hospital, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ceila E.","family":"Loughlin","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, School of Medicine, University of North Carolina and North Carolina Children\u2019s Hospital, Chapel Hill, North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"417","published-online":{"date-parts":[[2021,1,1]]},"reference":[{"author":"Adams","key":"2021120907014173500_B1","article-title":"Surgeon general\u2019s advisory on e-cigarette use among youth."},{"article-title":"Outbreak of lung injury associated with the use of e-cigarette, or vaping, products.","year":"2020","author":"Centers for Disease Control and Prevention","key":"2021120907014173500_B2"},{"issue":"45","key":"2021120907014173500_B3","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.15585\/mmwr.mm6745a5","article-title":"Notes from the field: use of electronic cigarettes and any tobacco product among middle and high school students - United States, 2011\u20132018","volume":"67","author":"Cullen","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"3","key":"2021120907014173500_B4","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1001\/jamapediatrics.2016.4662","article-title":"E-cigarette use among youth and young adults: a major public health concern","volume":"171","author":"Murthy","year":"2017","journal-title":"JAMA Pediatr"},{"key":"2021120907014173500_B5","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.pmedr.2016.06.002","article-title":"Potential health effects of electronic cigarettes: a systematic review of case reports","volume":"4","author":"Hua","year":"2016","journal-title":"Prev Med Rep"},{"issue":"1","key":"2021120907014173500_B6","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1111\/nyas.12977","article-title":"Electronic cigarettes: what are they and what do they do?","volume":"1394","author":"Breland","year":"2017","journal-title":"Ann N Y Acad Sci"},{"author":"Centers for Disease Control and Prevention","key":"2021120907014173500_B7","article-title":"The Emergency Response Safety and Health Database."},{"issue":"10","key":"2021120907014173500_B8","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1056\/NEJMoa1911614","article-title":"Pulmonary illness related to e-cigarette use in Illinois and Wisconsin - final report","volume":"382","author":"Layden","year":"2020","journal-title":"N Engl J Med"},{"issue":"18","key":"2021120907014173500_B9","doi-asserted-by":"crossref","first-page":"1780","DOI":"10.1056\/NEJMc1913069","article-title":"Pathology of vaping-associated lung injury","volume":"381","author":"Butt","year":"2019","journal-title":"N Engl J Med"},{"issue":"6","key":"2021120907014173500_B10","doi-asserted-by":"crossref","first-page":"e20163927","DOI":"10.1542\/peds.2016-3927","article-title":"Hypersensitivity pneumonitis and acute respiratory distress syndrome from e-cigarette use","volume":"141","author":"Sommerfeld","year":"2018","journal-title":"Pediatrics"},{"issue":"41","key":"2021120907014173500_B11","doi-asserted-by":"crossref","first-page":"919","DOI":"10.15585\/mmwr.mm6841e3","article-title":"Update: interim guidance for health care providers evaluating and caring for patients with suspected e-cigarette, or vaping, product use associated lung injury - United States, October 2019","volume":"68","author":"Siegel","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"36","key":"2021120907014173500_B12","doi-asserted-by":"crossref","first-page":"787","DOI":"10.15585\/mmwr.mm6836e2","article-title":"Severe pulmonary disease associated with electronic-cigarette-product use - 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