A Case of Drug Induced Lung Injury Considered to Be Caused by a Supplement "Nin-niku Ran-ou (Garlic and Egg Yolk) "

Abstract

Background. Many types of health foods are sold all over the world. A considerable number of patients take them together with their medication. In Japan, garlic and egg yolk supplements are frequently advertised, and are purchased by numerous customers. Case. A male patient aged 69 years had been taking garlic and egg yolk supplements for 4 years. He complained of shortness of breath and dry cough that lasted for a couple of weeks. Subsequently, he went to a hospital and was diagnosed with treatment-resistant pneumonia. The patient was treated with antibiotics and corticosteroids, but his symptoms did not improve. Consequently, he was transferred to our hospital. A chest plain computed tomography scan showed ground glass opacity in the bilateral middle to lower field. Bronchoalveolar lavage showed lymphocyte predominant infiltration. A specimen of transbronchial lung biopsy showed mild lymphocytic inflammation and mild organizing pneumonia. After the patient stopped taking garlic and egg yolk supplements, his symptoms improved quickly. A lymphocyte stimulating test using the same merchandise showed a positive result. Therefore, we considered garlic and egg yolk supplements might be a cause of the lung disorder in this case. Conclusion. Asking patients their histories of taking health foods and dietary supplements can lead to a diagnosis of lung injury.