However different chemical compounds or lung diseases also can trigger popcorn lung.
"Given the patient's intense vaping exposure to flavoured e-liquid and negative workup for other causes of bronchiolitis, we suspected that bronchiolitis obliterans might have been developing in this patient as in microwave popcorn factory workers exposed to occupational inhalation of diacetyl".
His injuries were similar to those observed in people suffering from 'popcorn lung, ' a condition found in workers in a microwave popcorn factory who had accidentally inhaled diacetyl, a product used by the food industry which gives popcorn a buttery flavor.
In the U.S., the lungs of patents presented various injuries, but mainly alveolar lesions in the air sacs at the end of the airways.
"This patient had severe, acute bronchiolitis, possibly related to inhalational injury from vaping, with several features suggestive of subsequent early bronchiolitis obliterans ['popcorn lung']", they write.
The patient developed a severe cough that caused him to seek medical attention, according to the report.
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The teen had vaped heavily each day for five months before he first saw symptoms and said he usually cycled between green apple, cotton candy and "dew mountain" cartridge flavors purchased online.
As the patient's symptoms progressed, he eventually had trouble breathing, malaise and nausea. He was put on oxygen, given intravenous antibiotics and was admitted to the hospital. His lungs were so damaged that he had to be placed on an extracorporeal membrane oxygenation (ECMO) machine, which pumps blood through an artificial lung outside the body.
The teen was transferred to a lung transplant centre in Toronto, where Dr. Tereza Martinu said she and other colleagues took over his care.
He narrowly avoided the need for a double lung transplant, doctors said, but appears to be left with chronic lung damage.
"This case may represent the first direct evidence of the lung disease most expected to result from e-cigarette use", said Dr Matthew Stanbrook, Deputy Editor, CMAJ. Numerous 2,000 vaping illness patients in the United States have damage in the spongelike tissue of their lungs called alveoli, or air sacs.
In September, President Donald Trump pledged to ban sale of most flavored e-cigarettes in the United States.
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"For popcorn lung, the actual scientific name is bronchiolitis obliterans, and the bronchiolitis obliterans name implies obliterating the bronchioles, the most distal part of the lungs - and that's what that disease did". "I think what we are recognizing now is that these toxins that are in the electronic cigarettes are toxins for a reason".
A Canadian runt one who used e-cigarettes developed a shut to-fatal lung condition that does no longer resemble the vaping-connected ailments that believe swept the US.
Some 42 deaths have been confirmed in 24 states and more are under investigation.
Diacetyl has been found in e-cigarettes before; indeed, in 2016, the American Lung Association even warned about the risks of diacetyl in flavored e-cigarettes.
Vitamin E acetate, a common substance approved for foods and cosmetics, causes an immune reaction similar to pneumonia in the lungs when vaporized and inhaled.
Earlier this year Canada's chief medical officers of health issued a statement warning that vaping among youth had spiked alarmingly, and Canadian provinces including British Columbia and Prince Edward Island are exploring legislation to limit youth access to e-cigarettes.
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"What happened to him could happen to anyone", Dr. Karen Bosma, lead author of the report, added.