title: Sirolimus-induced pneumonitis: three cases and a review of the literature.
abstract: Interstitial pneumonitis is a rare disease that is seen in the context of some infections (e.g. PCP and CMV pneumonia), as side-effects of drugs (e.g. beta-blockers, amiodarone) and rarely in the context of renal transplantation. It manifests itself usually as a pneumonic illness; with symptoms of dyspnea, cough, fatigue and sometimes fever. Characteristic radiological changes are bilateral lower zone haziness. Interstitial pneumonitis is now emerging in solid organ transplant patients secondary to sirolimus). We describe three cases of sirolimus-induced pneumonitis in two patients who started sirolimus to permit cyclosporin withdrawal and in one patient initially started on sirolimus. The presentations in these cases ranged from insidious to fulminant; there was a rapid response to sirolimus withdrawal. This is an important syndrome, with an unknown frequency.
authors.affiliation: Renal and Transplantation Unit, Guy's and St Thomas' Hospital, London, UK.
authors.forename: Ali A
authors.initials: AA
authors.lastname: Haydar
authors.forename: Mark
authors.initials: M
authors.lastname: Denton
authors.forename: Alex
authors.initials: A
authors.lastname: West
authors.forename: John
authors.initials: J
authors.lastname: Rees
authors.forename: David J A
authors.initials: DJ
authors.lastname: Goldsmith
mesh_terms: D000368:Aged; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods*; D008168:Lung / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced* / Q000175:diagnosis*; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014180:Transplantation
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus