Intraoperative Bleeding Associated with Preoperative Use of Ganoderma lucidum Supplements

Reishi mushroom, also known as Ganoderma lucidum, is a type of edible medicinal fungi that is found throughout Asia. Recent research has shown that it may also have antiplatelet activity that is similar to aspirin. Likewise simvastatin has been shown to inhibit platelet aggregation. In addition, montelukast has anecdotally related to one case of acquired thrombopathia and may interfere with platelet aggregation. We report a case of intraoperative hemorrhage with laparoscopic trocar placement and dissection in a patient concomitantly taking Ganoderma lucidum supplements, simvastatin and montelukast. The hemorrhage only responded to a transfusion of platelets. We believe this is the first report associating Ganoderma lucidum products with an intraoperative hemorrhage. We recommend that patients who are on simvastatin, montelukast or an anticoagulant should refrain from taking Ganoderma lucidum products for seven days prior to surgery.