Department of Respiratory Medicine, Kitaharima Medical Center, 926-250 Ichiba-Cho, Ono, Hyogo, 675-1392, Japan.
Department of Respiratory Medicine, Kyoto University Hospital, 54 Shogoin-Kawaharacho, Sakyo, Kyoto, 606-8507, Japan.
J Med Case Rep. 2023 Feb 27;17(1):83. doi: 10.1186/s13256-022-03717-9.
We report a rare case of drug-induced interstitial lung disease due to over-the-counter cold medicine taken daily for 25 years to clear the patient's head.
A 77-year-old Japanese man presented to our hospital with a worsening cough that started 5 years ago. Chest radiographs and computed tomography images showed bilateral opacities, and transbronchial lung biopsy specimens showed an organizing pneumonia pattern. He reported taking the same over-the-counter cold medicine daily for the past 25 years to clear his head. We suspected that the cold medicine caused the lung opacities and asked him to stop taking them. His cough, general fatigue, and chest infiltrate gradually diminished. However, 6 months later, he resumed the same treatment because of a cold. The following month, he presented with severe worsening cough and chest radiographical findings. We diagnosed drug-induced interstitial lung disease. He improved by stopping the cold medicine again and taking prednisolone.
Over-the-counter cold medicines are easily accessible at the drugstore. In cases of diffuse lung disease, we should consider drug-induced interstitial lung disease due to over-the-counter cold medicine, which patients have been taking not only for weeks or months but also years.
我们报告了一例罕见的因长期（25 年）每日服用非处方感冒药以缓解头痛而导致的药物性间质性肺病。
一名 77 岁日本男性因 5 年前开始出现的逐渐加重的咳嗽就诊于我院。胸部 X 线片和 CT 图像显示双侧混浊，经支气管肺活检标本显示为机化性肺炎模式。他自述过去 25 年每天都服用同一种非处方感冒药来缓解头痛。我们怀疑是感冒药引起了肺部混浊，并要求他停止服用。他的咳嗽、全身乏力和胸部浸润逐渐减轻。然而，6 个月后，他因感冒再次开始服用相同的药物。次月，他因严重咳嗽恶化和胸部影像学表现而就诊。我们诊断为药物性间质性肺病。他再次停止服用感冒药并服用泼尼松龙后有所改善。
非处方感冒药在药店随处可得。在弥漫性肺病的情况下，我们应考虑药物性间质性肺病，因为患者不仅服用了数周或数月，甚至数年的非处方感冒药。
