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A 64-year-old man who ingested liquid paraffin as a laxative for over two years, was admitted to our hospital with a persistent interstitial lung shadow and marked elevation of serum KL-6. He had no overt symptoms although his chest radiograph revealed ground glass opacities in the left lower lung field and right middle and lower lung fields. We performed fiberoptic bronchoscopy. Exogenous lipoid pneumonia was diagnosed based on microscopic analysis of the bronchoalveolar lavage fluid that revealed the presence of lipid-laden alveolar macrophages. We instructed the patient to discontinue liquid paraffin ingestion and observed his clinical course. The chest radiograph and thoracic computed tomography revealed a tendency to improve and serum KL-6 decreased with time. Serum KL-6 may be an important index of the severity of exogenous lipoid pneumonia.

The state of conjunctival microcirculation, thromboelastographic hemocoagulation by 10 indices and 8 fractions of citrated blood plasma phospholipids was studied in 145 patients with acute pneumonia. Microcirculatory disorders with an increase in all conjunctival indices, marked hypercoagulation with raised concentration of phosphatidylethanolamine, lysophosphatidylcholines in parallel with a decrease in the level of phosphatidylcholines of the blood plasma, particularly at the peak of an inflammatory pulmonary process, were found. The relationship of phospholipids with plasma coagulation and microcirculation as a result of the development of a pathological pulmonary process was revealed.

A patient with hypercalcemia, suppressed serum PTH levels, and elevated serum levels of calcitriol was found to have a granulomatous lipoid pneumonia due to chronic aspiration of a "vaporizing ointment." After the surgical removal of the largest granuloma, the serum calcium and calcitriol levels rapidly returned to normal. This is a new instance of granuloma-induced hypercalcemia, probably mediated by the activation of vitamin D by cells of the granulomatous reaction.