Untitled

Abstract

The use of inhibitors of mammalian target of rapamycin is associated with adverse pulmonary effects. Although sirolimus-related pneumonitis has been well described, reports on pneumonitis with everolimus are scarce. We report a case of everolimusinduced pneumonitis in a renal transplant recipient 5 years after initiation of everolimus treatment, and we also review the literature regarding everolimusinduced pneumonitis in renal transplant patients.

Pulmonary Complications of Everolimus in Liver Transplant Patients: A 10-Year Experience

“…Subsequently, chest imaging with X-ray and CT scans showed varying pulmonary infiltrates in these patients [5,6,14]. Interestingly, plasma serum levels of everolimus are suspected to play a role in pulmonary toxicity in solid organ transplant, and several of the reported liver transplant serum levels were either slightly below or within therapeutic levels of 5.0 to 12.0 ng/mL [5,[10][11][12]. In the reported liver transplant cases, everolimus was eventually discontinued and patients were treated with or without corticosteroids.…”

“…While the mechanism of everolimus-associated pulmonary complications is not understood, some investigators have speculated that mTOR inhibition is associated with activation of the STAT1 gene, leading to increased apoptosis and injury; others theorize that a STAT3 polymorphism may increase the risk of interstitial lung disease with mTOR inhibitors [8,9]. Moreover, studies have also indicated that pulmonary toxicity seen with mTOR inhibitors correlated with higher doses of the medication [10].…”