Bacterial Pneumonia with Chest Pain Successfully Treated with Saikanto in a Patient with an Antimicrobial Allergy / 日本東洋医学雑誌

A 64 year-old female presented with fever and cough. She had suffered from a cough for one day and we treated her with saikokeishito. However, her symptoms got worse and she developed chest pain. She was diagnosed with bacterial pneumonia at another clinic and she was referred to our hospital 3 days after starting saikokeishito. Her X-ray showed right infiltration in her lung and her blood examination had signs of inflammation. Pneumonia with pleuritis was suspected, but she was allergic to antibacterial drugs and hoped to continue Kampo treatment. We switched saikokeishito to saikanto. Her chest pain decreased soon after taking saikanto and 4 days later only a slight cough remained. Eleven days later, her inflammatory reaction improved. Kampo formulas containing Bupleuri radix are usually selected for pneumonia or pleuritis according to a patient' s pattern identification. We gave her saikanto, a mixture of shosaikoto and shokankyoto, because she had chest pain. Saikanto was significantly effective. There have been few clinical reports about treatment for pneumonia with Kampo medicine alone without using antibacterial drugs. We believe this case shows that Kampo treatment is effective for pneumonia and pleuritis.

A Case of Pleural Effusion Due to Bacterial Pleurisy Markedly Reduced by Treatment with Saikanto / 日本東洋医学雑誌

Although saikanto has often been used for infectious pleuritis, there are few reports on the usefulness of it in recent years. We experienced a patient successfully treated with saikanto, who was suffering from bacterial pleuritis with residual pleural effusion, which was difficult to drain and treat with antibacterial drugs. Kampo treatment including saikanto should be used for pleuritis that is not sufficiently improved by Western medical treatment alone.

A Case of Dasatinib-induced Pleural Effusion Accompanied by Philadelphia Chromosome-positive Acute Lymphoblastic Leukemia, Successfully Treated with Saikanto / 日本東洋医学雑誌

We report a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) in whom saikanto was effective against pleural effusion induced by dasatinib, which is a second-generation tyrosine kinase inhibitor. The patient was a 43-year-old female. After she was diagnosed with Ph+ALL, she received imatinib and other chemotherapy. One year later, she started to receive dasatinib because of imatinib intolerance (vomiting and diarrhea). After about seven months of taking dasatinib, she experienced chest/back pain and a cough; at that time her chest x-ray showed right-sided pleural effusion. She consulted our clinic three months later, for treatment of the hydrothorax that frequently recurred. We prescribed saikanto because she presented with epigastric tenderness diagnosed as <i>shokekkyo</i>, and the pleural effusion and clinical symptoms improved remarkably. Because of the good clinical course in this case, we consider that the decrease of pleural effusion was caused mainly by the immunoregulatory and anti-inflammatory activities of saikanto in addition to its activities to alleviate fluid retention.