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Lee, Choo, Bang, Kim, Park, Jee, Kim, and Myong: A Case of Hypersensitivity Pneumonitis Following Placenta Extract Injection
Case Report
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2009; 66(6): 471-476.

Published online: 30 June 2009

DOI: https://doi.org/10.4046/trd.2009.66.6.471

A Case of Hypersensitivity Pneumonitis Following Placenta Extract Injection

Sang Seok Lee, M.D.1, Young Kwang Choo, M.D.1, Chang Seok Bang, M.D.1, Youn Seup Kim, M.D.1, Jae Seuk Park, M.D.1, Young Koo Jee, M.D.1, Doh Hyung Kim, M.D.1, Na Hye Myong, M.D.2

1Division of Pulmonology and Allergy, Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea.

2Department of Pathology, Dankook University College of Medicine, Cheonan, Korea.

Address for correspondence: Doh Hyung Kim, M.D., Ph.D. Division of Pulmonology and Allergy, Department of Internal Medicine, Dankook University College of Medicine, 16-5, Anseo-dong, Cheonan 330-715, Korea. Phone: 82-41-550-3870, Fax: 82-41-556-3256, kimdh@dankook.ac.kr

Received 18 May 2009       Accepted 19 June 2009

Copyright©2009. The Korean Academy of Tuberculosis and Respiratory Diseases. All rights reserved.

Abstract

Human placenta contains various kinds of nutritional elements essential for embryonic development. Currently, human placenta extracts are widely overused in Korea to improve certain health conditions (postmenopausal syndrome, liver function, and cosmetic purposes) without scientific evidence that they actually work. The use of placenta extracts should be restricted, due to a lack of systematic research on the therapeutic effectiveness and adverse results from these treatments. While the common adverse effects that have been reported are fever, rash, itching, nausea, vomiting, breast pain, and rare cases of anaphylactic shock, there have been no reports of pulmonary complications such as hypersensitivity pneumonitis. Recently, we experienced a patient with hypersensitivity pneumonitis following a placenta extract injection. To our knowledge, this is the first case of hypersensitivity pneumonitis associated with placenta extract use.

Keywords: Placenta, Placenta extract, Hypersensitivity pneumonitis

Figures and Tables

Figure 1
Chest X-ray. (A) The chest PA on admission shows widespread, bilateral, air space consolidation which is more marked in the middle and lower lung zones. Also seen are multiple, poorly defined nodular opacities. (B) Six weeks after steroid treatment, diffuse air space consolidation is almost completely disappeared.
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Figure 2
HRCT scan. Initial HRCT scan shows diffuse, the mixed area of consolidation and ground-glass attenuation. Some area of consolidation is predominantly distributed in peripheral lung zone. Normal and abnormal secondary pulmonary lobules are sharply demarcated.
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Figure 3
Open lung biopsy. (A) Lymphocyte infiltration and small non-caseating granulomas are predominantly found in the peribronchiolar interstitium (H&E stain, ×100). (B) Higher magnification of granuloma shows epithelioid histiocytes and multinucleated giant cells (H&E stain, ×400). (C, D) The interstitial infiltrates are predominantly CD8 positive (C: CD8 immunostain, ×400, D: CD4 immunostain, ×400).
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Figure 4
HRCT after steroid treatment. Six weeks after steroid treatment, diffuse air space consolidation has been almost completely disappeared. Ill-defined opacity in right upper lung zone is post-operative change due to previous VATS biopsy (arrow).
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Young Koo Jee
https://orcid.org/http://orcid.org/0000-0001-5800-8038

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