CLINICAL-FEATURES OF PNEUMONITIS INDUCED BY HERBAL DRUGS

The aim of this study was to call attention to interstitial pneumoniti s as an adverse effect of herbal drugs, Twenty-four cases (22 patients ) with herbal drug-induced pneumonitis were reviewed based on the Japa nese 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 oth ers a diffuse interstitial pneumonitis, The duration of herbal drug in take was variable from a period of one day to several months, Major cl inical symptoms were dyspnoea, cough and fever, and the laboratory dat a showed hypoxaemia and positive inflammatory reactions with increased WBC and raised ESR and CRP. Results of bronchoalveolar lavage (BAL) s howed an increased lymphocyte or neutrophil population and a low OKT4/ OKT8 ratio, The in vitro lymphocyte stimulation test (LST) was positiv e 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 inte rstitial pneumonitis when we treat patients with herbal drugs. (C) 199 7 by John Wiley & Sons, Ltd.