Dramatically Improved Severe Pulmonary Arterial Hypertension Caused by Qing-Dai (Chinese Herbal Drug) for Ulcerative Colitis

Abstract

Pulmonary arterial hypertension (PAH) is a rare and fatal disease for which some causative drugs have been developed. Qing-Dai is a Chinese herbal drug that is sometimes used as a specific treatment for ulcerative colitis in Asia, including Japan. Here, we report a case of severe Qing-Dai-induced PAH. A 19-year-old woman who has been taking Qing-Dai for 8 months was admitted for exertional dyspnea. Her mean pulmonary artery pressure dramatically improved from 72 to 18 mmHg with Qing-Dai discontinuation and PAH-specific therapy. After 6 years of onset, she had not relapsed with PAH with PAH-specific therapy.

Indigo Naturalis in Inflammatory Bowel Disease: mechanisms of action and insights from clinical trials

“…In the same study, one case was reported where liver levels increased 10 times the upper limit of normal. Recently, many cases of pulmonary hypertension have been reported in patients taking green tea for UC [ 58 - 60 ]. These cases have a common rapid improvement after stopping taking IN.…”

Analysis of Crude, Diverse, and Multiple Advanced Glycation End-Product Patterns May Be Important and Beneficial

“…Because BMI was reduced, we consider that Bofutsushosan was able to improve obesity. Although Seitai (Chinese name: Qing-Dai) was known as the crude drug that had therapeutic effects for ulcerative colitis, which may be associated with LSRDs, it improved the pulmonary arterial hypertension of the patients with ulcerative colitis [ 107 , 108 ]. Kampo medicines may inhibit the generation of intracellular AGEs, block the extracellular AGEs-RAGE/TRL4 axis, and suppress phenotypes via AGEs-RAGE/TRL4 axis signaling.…”

Letter by Frumkin Regarding Article, "Dramatically Improved Severe Pulmonary Arterial Hypertension Caused by Qing-Dai (Chinese Herbal Drug) for Ulcerative Colitis."

“…The report by Kubota, et al 1) of a patient with severe Qing-Dai-induced pulmonary arterial hypertension (PAH) underscores a need to reclassify the relationship between PAH and certain drugs and toxins, first introduced at the 6th World Symposium on Pulmonary Hypertension in 2018. 2) The current classification notes that indirubin (Chinese herb Qing-Dai) is possibly related to PAH.…”