Pneumonitis induced by ou-gon (scullcap)

A 53-year-old Japanese man with recurrent interstitial pneumonia was referr ed to us. The patient had taken a traditional herb medicine, otsu-ji-to, be fore the onset of pneumonia. A provocation test for each herbal ingredient contained in otsu-ji-to revealed that the pneumonitis had been induced by o u-gon (scullcap). Lymphocytosis with the CD8+ T-cell subset predominance wa s found in the bronchoalveolar lavage fluid and lymphocytic alveolitis was noted in the transbronchial lung biopsy specimen after the provocation test . Ou-gon, or scullcap, should be included in the list of drugs with definit e causal association with pneumonitis.