2012 Volume 34 Issue 6 Pages 558-563
Background. Bofu-tsusho-san is a herbal medicine sold as an over-the-counter medicine in Japan for losing weight. We report a case of severe drug-induced pneumonitis which was caused by it. Case. A 66-year-old woman was admitted to our hospital with dyspnea and fever. Three weeks before admission, she had started to take an over-the-counter herbal medicine, bofu-tsusho-san. Chest CT showed diffuse ground glass attenuation in both lung fields. Thereafter, her respiratory condition deteriorated progressively and mechanical ventilation was needed. Bronchoalveolar lavage fluid showed a high percentage of eosinophils and lymphocytes. Drug-induced pneumonitis caused by bofu-tsusho-san was diagnosed, and was treated successfully with steroid therapy. The results of drug lymphocyte stimulation test for bofu-tsusho-san were positive. Conclusion. Clinicians should recognize the potential of drug-induced pneumonitis caused by over-the-counter herbal medicine.