Tsuchiya Kazuo, Miyamoto Ryota, Tsunoda Tomo, Ito Taisuke, Akashi Takuro, Oyama Yoshiyuki, Ikeda Masaki
Department of Respiratory Medicine, Shizuoka Saiseikai General Hospital, Japan.
Intern Med. 2025 Sep 1;64(17):2637-2640. doi: 10.2169/internalmedicine.4960-24. Epub 2025 Mar 8.
Although there have been several reports of drug-induced pneumonitis caused by herbal medicines in recent years, herbal medicine-induced diffuse alveolar hemorrhage (DAH) is rare. We herein report two cases of DAH associated with herbal medicines. Patient 1 developed dyspnea and hemoptysis after receiving jidabokuippo. Patient 2 developed a fever and dyspnea after taking otsuji-to. Both patients exhibited severe respiratory failure, and bronchoalveolar lavage revealed bloody fluid that confirmed the diagnosis of DAH. In both patients, discontinuation of herbal medicines and corticosteroid therapy resulted in significant improvement. These cases highlight the potential risks of DAH associated with herbal medicines.
尽管近年来已有数篇关于草药引起药物性肺炎的报道，但草药引起的弥漫性肺泡出血（DAH）却很罕见。我们在此报告两例与草药相关的DAH病例。病例1在服用积大保肺丸后出现呼吸困难和咯血。病例2在服用大柴胡汤后出现发热和呼吸困难。两名患者均表现出严重的呼吸衰竭，支气管肺泡灌洗显示血性液体，确诊为DAH。两名患者停用草药并接受皮质类固醇治疗后均有显著改善。这些病例凸显了与草药相关的DAH的潜在风险。
