PDF(Pubmed)
Abstract：
Kampo medicine, a traditional Japanese herbal medicine, is covered by the Japanese National Health Insurance and prescribed for various purposes. While relatively safe with few adverse effects, it may potentially cause severe adverse effects, such as lung injury. Herein, we describe the case of a 61-year-old Japanese woman with choreito-induced lung injury that manifested as organizing pneumonia (OP) with diffuse alveolar hemorrhage (DAH). She was referred to our department due to multiple abnormal opacities detected on annual chest radiography. Chest computed tomography (CT) revealed multiple nodules in bilateral lungs. Bloody bronchoalveolar lavage fluid was obtained from the left lingular lobe, appearing nearly normal, while a transbronchial lung biopsy from a subpleural nodule in the left lower lobe was pathologically consistent with OP. The drug lymphocyte stimulation test result was positive for choreito, which the patient had regularly consumed for 6 - 7 months to treat hematuria. Consequently, a diagnosis of choreito-induced OP and DAH was made. Owing to the discontinuation of choreito alone and without the introduction of systemic steroid therapy, the multiple nodules shrank and eventually disappeared on follow-up chest CT. Regardless of the type of crude drug used in Kampo medicine, clinicians must always be careful for potential lung injury, which may present as OP with DAH.
摘要：
康波药,一种传统的日本草药，由日本国民健康保险承保，并为各种目的规定。虽然相对安全，不良反应少，它可能会导致严重的不良影响，如肺损伤。在这里，我们描述了1例61岁的日本女性发生舞蹈诱导的肺损伤,表现为机化性肺炎(OP)伴弥漫性肺泡出血(DAH).由于每年的胸部X线检查发现了多个异常混浊，她被转诊到我们部门。胸部CT显示双肺多发结节。从左舌叶获得血腥的支气管肺泡灌洗液，看起来几乎正常，而左下叶胸膜下结节的经支气管肺活检在病理上与OP一致。药物淋巴细胞刺激试验结果为舞蹈阳性，患者经常服用6-7个月来治疗血尿。因此,诊断为舞蹈诱导的OP和DAH。由于单独停止了choreito，并且没有引入全身性类固醇治疗，在随访的胸部CT上，多个结节缩小并最终消失。无论康波药物使用哪种原料药，临床医生必须始终小心潜在的肺损伤，这可能与DAH一起呈现为OP。
