Tahara Masahiro, Yamasaki Kei, Ikegami Hiroaki, Fukuda Yoko, Uchimura Keigo, Tachiwada Takashi, Noguchi Shingo, Kawanami Toshinori, Kido Takashi, Mukae Hiroshi, Yatera Kazuhiro
Department of Respiratory Medicine, School of Medicine, University of Occupational and Environmental Health, Japan.
Second Department of Internal Medicine, Nagasaki University School of Medicine.
J UOEH. 2019;41(1):51-56. doi: 10.7888/juoeh.41.51.
An eighty-nine-year-old Japanese male was admitted to our hospital due to dry cough and dyspnea. Respiratory symptoms appeared soon after an administration of an oriental medicine, Kamikihito for tinnitus. Upon admission, chest computed tomography showed patchy consolidations and ground-glass opacities in the right upper lobe of the lungs, and ground-glass opacities in the bilateral lower lobes. Sulbactam-ampicillin combination (SBT/ABPC, 3 g × 2/day) was started in addition to the change or cessation of several other drugs, including Kamikihito, resulting in respiratory symptoms and chest radiographic exacerbations. Bronchoalveolar lavage fluid obtained from the right S showed an increase in the total cell number of lymphocytes. A drug lymphocyte stimulation test (DLST) for Kamikihito was also positive. Kamikihito-induced lung injury was most likely, and treatment with prednisolone (50 mg/day) was started. His respiratory symptoms and chest radiographic findings improved rapidly soon after initiating oral prednisolone. This is the first report of Kamikihito-induced lung injury.
一名89岁的日本男性因干咳和呼吸困难入院。在服用一种用于治疗耳鸣的中药“加味逍遥散”后不久，呼吸道症状就出现了。入院时，胸部计算机断层扫描显示右肺上叶有斑片状实变和磨玻璃影，双下叶有磨玻璃影。除了更换或停用包括加味逍遥散在内的其他几种药物外，还开始使用舒巴坦-氨苄西林组合（SBT/ABPC，3g×2/天），结果导致呼吸道症状和胸部影像学加重。从右侧获取的支气管肺泡灌洗液显示淋巴细胞总数增加。加味逍遥散的药物淋巴细胞刺激试验（DLST）也呈阳性。很可能是加味逍遥散引起的肺损伤，开始使用泼尼松龙（50mg/天）进行治疗。开始口服泼尼松龙后不久，他的呼吸道症状和胸部影像学表现迅速改善。这是关于加味逍遥散引起肺损伤的首例报告。
