So far more than 350 drugs have been reported to be the cause for lung injury and the incidence tends to increase. Although infiltrative lung disease is the most common pattern of drug-induced lung injury, it can appear in the form of alveolar changes, vasculitis and other injury. Herbal medicine also has been known as a cause for interstitial pneumonitis, but it is difficult to identify the key herbal medicine because of the complex components of the contents. Till date, there is no report of pneumonitis caused by golden thread. Here we report a case of a 54-year-old male who developed interstitial pneumonitis with acute liver injury caused by herbal medicine made from golden thread.
Drugs, Chinese Herbal ; Herbal Medicine ; Humans ; Incidence ; Liver ; Lung Diseases ; Lung Diseases, Interstitial ; Lung Injury ; Male ; Middle Aged ; Pneumonia ; Vasculitis

Respiratory bronchiolitis-associated interstitial lung disease is one of the smoking-related interstitial lung diseases. Histopathologically, it shows respiratory bronchiolitis, which is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles, accompanying peribronchiolar inflammation. Clinically, it is presented with respiratory symptoms such as a cough, sputum and dyspnea on exertion. It is well known that the incidence of malignancy in interstitial lung disease is high, but in respiratory bronchiolitis-associated interstitial lung disease the report of accompanying malignancy is rare. Here we report a case of a 60-year-old male heavy smoker presented with a cough, sputum and clubbing finger. A chest computed tomography (CT) of the patient did not show any shadow suspected of malignancy, but adenocarcinoma was found on a transbronchial lung biopsy and on a surgical lung biopsy with respiratory bronchiolitis-associated interstitial lung disease.
Adenocarcinoma ; Biopsy ; Bronchioles ; Bronchiolitis ; Carcinoma, Non-Small-Cell Lung ; Cough ; Dyspnea ; Fingers ; Humans ; Incidence ; Inflammation ; Lung ; Lung Diseases, Interstitial ; Macrophages ; Male ; Middle Aged ; Sputum ; Thorax