Some sage advice: A case report of sage burning causing interstitial lung disease

Background: Cigarette smoking remains the commonest cause of chronic obstructive pulmonary disease (COPD) and respiratory bronchiolitis-associated interstitial lung disease (RB-ILD). Biomass combustion remains a high risk for causing respiratory disease. Method: We present a case of a 41-year-old wo...

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Main Authors: Jonathan Ayling-Smith, Richard Attanoos, Nicola-Xan Hutchinson
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Clinical Medicine
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S1470211825000557
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author Jonathan Ayling-Smith
Richard Attanoos
Nicola-Xan Hutchinson
author_facet Jonathan Ayling-Smith
Richard Attanoos
Nicola-Xan Hutchinson
author_sort Jonathan Ayling-Smith
collection DOAJ
description Background: Cigarette smoking remains the commonest cause of chronic obstructive pulmonary disease (COPD) and respiratory bronchiolitis-associated interstitial lung disease (RB-ILD). Biomass combustion remains a high risk for causing respiratory disease. Method: We present a case of a 41-year-old woman and never-smoker with worsening breathlessness. It was identified that she made fire pits burning sage and oils for spiritual work, but beyond this had no respiratory risk factors. Results: Radiological evidence of RB-ILD was identified and a bronchoscopic lavage demonstrated the presence of striking green pigmented macrophages, presumed to be chlorophyll uptake. Conclusions: Cessation of burning sage exposure has resulted in a positive outcome. This case highlights the need for an extensive occupational or exposure history in respiratory medicine and describes histological features of interstitial lung disease not previously identified.
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spelling doaj-art-7a0fc94f303145bfb8ee3aa0647dbcbe2025-08-20T03:41:14ZengElsevierClinical Medicine1470-21182025-07-0125410033710.1016/j.clinme.2025.100337Some sage advice: A case report of sage burning causing interstitial lung diseaseJonathan Ayling-Smith0Richard Attanoos1Nicola-Xan Hutchinson2Department of Respiratory Medicine, Cardiff and Vale University Health Board, Cardiff, Wales, UK; Corresponding author.Department of Cellular Pathology, University Hospital of Wales, Cardiff, Wales, UK; School of Medicine, Cardiff University, Cardiff, UKDepartment of Respiratory Medicine, Cardiff and Vale University Health Board, Cardiff, Wales, UKBackground: Cigarette smoking remains the commonest cause of chronic obstructive pulmonary disease (COPD) and respiratory bronchiolitis-associated interstitial lung disease (RB-ILD). Biomass combustion remains a high risk for causing respiratory disease. Method: We present a case of a 41-year-old woman and never-smoker with worsening breathlessness. It was identified that she made fire pits burning sage and oils for spiritual work, but beyond this had no respiratory risk factors. Results: Radiological evidence of RB-ILD was identified and a bronchoscopic lavage demonstrated the presence of striking green pigmented macrophages, presumed to be chlorophyll uptake. Conclusions: Cessation of burning sage exposure has resulted in a positive outcome. This case highlights the need for an extensive occupational or exposure history in respiratory medicine and describes histological features of interstitial lung disease not previously identified.http://www.sciencedirect.com/science/article/pii/S1470211825000557Case reportSageBurningILDRB-ILDBiomass
spellingShingle Jonathan Ayling-Smith
Richard Attanoos
Nicola-Xan Hutchinson
Some sage advice: A case report of sage burning causing interstitial lung disease
Clinical Medicine
Case report
Sage
Burning
ILD
RB-ILD
Biomass
title Some sage advice: A case report of sage burning causing interstitial lung disease
title_full Some sage advice: A case report of sage burning causing interstitial lung disease
title_fullStr Some sage advice: A case report of sage burning causing interstitial lung disease
title_full_unstemmed Some sage advice: A case report of sage burning causing interstitial lung disease
title_short Some sage advice: A case report of sage burning causing interstitial lung disease
title_sort some sage advice a case report of sage burning causing interstitial lung disease
topic Case report
Sage
Burning
ILD
RB-ILD
Biomass
url http://www.sciencedirect.com/science/article/pii/S1470211825000557
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