Clinical features of pneumonitis induced by herbal drugs

✍ Scribed by Yutaka Mizushima; Rokuo Oosaki; Masashi Kobayashi

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 93 KB
• Volume: 11
• Category: Article
• ISSN: 0951-418X
• DOI: 10.1002/(sici)1099-1573(199706)11:4<295::aid-ptr97>3.0.co;2-k

✦ Synopsis

The aim of this study was to call attention to interstitial pneumonitis as an adverse effect of herbal drugs. Twentyfour cases (22 patients) with herbal drug-induced pneumonitis were reviewed based on the Japanese medical literature. Eight types of herbal drugs were reported as causative agents, and 15 of the 24 cases were due to Sho-Saiko-to. On chest x-ray films, one patient with bronchial asthma showed a pattern of pulmonary infiltration with eosinophilia (PIE syndrome) and the others a diffuse interstitial pneumonitis. The duration of herbal drug intake was variable from a period of one day to several months. Major clinical symptoms were dyspnoea, cough and fever, and the laboratory data showed hypoxaemia and positive inflammatory reactions with increased WBC and raised ESR and CRP. Results of bronchoalveolar lavage (BAL) showed an increased lymphocyte or neutrophil population and a low OKT4/OKT8 ratio. The in vitro lymphocyte stimulation test (LST) was positive in 74% (17/23) of cases and the in vivo challenge test 100% (10/10). In conclusion, we should be attentive to adverse effects such as interstitial pneumonitis when we treat patients with herbal drugs.