A Case of Eosinophilic Pneumonia Caused by Hachimijiogan in Which Bronchoalveolar Lavage Was Useful for Differentiating Pulmonary Amiodarone Toxicity

Abstract

Background. Drug-induced lung injury caused by Hachimijiogan is rare. Case. A 70-year-old man with no history of respiratory disease developed ventricular fibrillation in early August 20XX-1 and was treated with 200 mg/day of amiodarone in the cardiology department of our hospital. In addition, the urology department of our hospital prescribed him 7.5 g/day of Hachimijiogan for benign prostatic hypertrophy. He began to experience cough by late August and dyspnea on exertion by mid-September and was admitted a short while later. Computed tomography revealed ground-glass opacity and consolidation in the peripheral areas of both lung fields. A cytologic analysis of the bronchoalveolar lavage fluid revealed a predominantly eosinophilic cell fraction with no foamy macrophages. A lymphocyte stimulation test showed positive results for Hachimijiogan. We therefore diagnosed the patient with drug-induced lung injury due to Hachimijiogan. Conclusion. We herein report a case of eosinophilic pneumonia caused by Hachimijiogan in which bronchoalveolar lavage was useful for differentiation from pulmonary amiodarone toxicity. Drug-induced lung injury caused by Hachimijiogan is rare, and there have been no previous reports of the disease.