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[Pneumonitis due to Hangeshashin-to]
1Department of Respiratory Medicine, Nagaoka Red Cross Hospital, Niigata, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi
|September 1, 1996
Summary
A rare case of drug-induced pneumonitis was identified in a 72-year-old woman. Hangeshashin-to, a traditional Japanese herbal medicine, was diagnosed as the cause of her pulmonary hypersensitivity.
Area of Science:
- Pulmonology
- Toxicology
- Immunology
Background:
- Drug-induced lung injury is a significant clinical concern.
- Traditional Japanese herbal medicines can cause adverse pulmonary reactions.
- Identifying the causative agent is crucial for patient management.
Observation:
- A 72-year-old woman presented with dyspnea and bilateral lung opacities on chest X-ray.
- Symptoms resolved upon cessation of all medications, suggesting drug-induced pneumonitis.
- Bronchoalveolar lavage revealed lymphocytosis and a low CD4/CD8 ratio.
- Open-lung biopsy showed lymphocytic infiltration consistent with pneumonitis.
Findings:
- Leukocyte migration inhibition tests were positive for Hangeshashin-to and Byakkokaninjin-to.
- Lymphocyte stimulation tests confirmed reactivity to Hange, an ingredient of Hangeshashin-to.
- A diagnosis of pneumonitis induced by Hangeshashin-to was established.
Implications:
- This case represents the first reported instance of pulmonary hypersensitivity to Hangeshashin-to in Japan.
- Highlights the importance of considering herbal medications in the differential diagnosis of drug-induced lung disease.
- Underscores the need for thorough patient history and diagnostic testing to identify rare adverse drug reactions.