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

Year: 2025

Type: article

Abstract: 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.

Source: Clinical Medicine

DOI: 10.1016/j.clinme.2025.100337

Authors: Jonathan Ayling-Smith, Richard Attanoos, Nicola-Xan Hutchinson

Institutions: Cardiff and Vale University Health Board, University Hospital of Wales, Cardiff University

Language: English

Topic: Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $2,500