Sirolimus-Induced Interstitial Pneumonitis After Renal Transplantation

A Pediatric Case of Sirolimus-Associated Pneumonitis After Kidney Transplantation

“…11,12 Previously described cases of sirolimus-induced pneumonitis demonstrated a wide spectrum of clinical presentations including being noted incidentally to being associated with a range of symptoms such as BUN, blood urea nitrogen; SRL, sirolimus ■ ■ BUN; ▲ ▲ Weight; • • Creatinine cough, fever, and patchy opacities on chest radiography non-responsive to antibiotic therapy. 13,14 This case shares similarities to previously described cases of sirolimus-induced lung toxicity in that our patient had allograft dysfunction, hypervolemia, and late exposure to sirolimus at the time of diagnosis. 15 Differences from more frequently cited risk factors for sirolimus-induced pneumonitis include subtherapeutic sirolimus concentrations, short duration of therapy, and young patient age.…”

Sirolimus-induced Alveolar Hemorrhage

“…Most of these cases involved sirolimus-induced interstitial pneumonitis and bronchiolitis obliterans organizing pneumonia (BOOP). 5,[15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Another uncommon side effect of sirolimus is diffuse AH, which has been reported in 9 cases (including the present case; Table 1). …”

Interstitial Granulomatous Pneumonitis associated with Sirolimus in a Child after Liver Transplantation

“…In many cases, unknown adverse events mimic common symptoms and signs, and physicians must consider a drug reaction in the differential diagnosis when confronted with common symptoms and signs amidst an unusual clinical course. A diagnosis of SRL toxicity in our patient with the non‐specific symptoms of dyspnea and fatigue was based on the four criteria for confirming the diagnosis of methotrexateinduced pneumonitis described by Henry et al (19). These criteria include exposure to the drug before the onset of pulmonary symptoms, exclusion of infection or alternative pulmonary disease, histopathology consistent with drug‐induced lung pathology, and new or evolving pulmonary infiltrates on chest radiographs.…”