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Ayurvedic medicine and the lung.
Chiao Yuen Lim1, Angela Takano, Steve Yang
1Division of Respiratory and Critical Care Medicine, National University Hospital, Singapore, Singapore.
Respiration; International Review of Thoracic Diseases
|February 22, 2014
Summary
Ayurvedic medicine use can cause hypersensitivity pneumonitis, a lung disease. Prompt diagnosis and treatment with steroids led to full recovery and no relapse in this case.
Area of Science:
- Pulmonology
- Toxicology
- Immunology
Background:
- Ayurvedic medicine is a traditional Indian system of medicine.
- Some Ayurvedic formulations may contain contaminants or unlisted ingredients.
- Hypersensitivity pneumonitis (HP) is an immune-mediated lung disease caused by inhaled antigens.
Observation:
- A middle-aged woman, never-smoker, presented with dyspnea, cough, and weight loss.
- High-resolution CT revealed diffuse centrilobular nodules and ground-glass attenuation.
- Bronchoalveolar lavage showed lymphocytosis with an elevated CD4/CD8 ratio.
Findings:
- Bronchoscopic lung biopsy demonstrated alveolitis with lymphocytic infiltration and noncaseating granulomas.
- Autoimmune screen was negative, ruling out autoimmune lung diseases.
- Diagnosis of hypersensitivity pneumonitis was established, linked to daily consumption of Ayurvedic tablets (Ostolief, Arthrella).
Implications:
- This case highlights the potential for Ayurvedic medicines to induce hypersensitivity pneumonitis.
- Early recognition and cessation of the offending agent are crucial for treatment.
- Treatment with corticosteroids and antibiotics resulted in complete radiological and clinical resolution.
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