Sirolimus-induced angioedema.
Sirolimus (SRL) is a macrolide immunosuppressant that has gained widespread use in organ transplantation. Its full spectrum of side-effects is yet to be defined. We describe herein three cases of SRL-induced angioedema (AE) in African-American (AA) primary renal allograft recipients who received SRL in combination with mycophenolate mofetil and steroids. In two cases, AE manifested after SRL was restarted after a period of discontinuation. The third case presented upon initial exposure to the drug. None of the patients was receiving any drug that has been previously associated with AE. Complete resolution occurred only after SRL was withdrawn. AE has not recurred in any of the patients during a follow-up period of up to 21 months. We conclude that AE is a previously unrecognized adverse event associated with SRL use. Close monitoring for this side-effect, especially in AA patients, is warranted.
Wadei
Hani
H
Division of Nephrology, Department of Medicine, Wayne State University School of Medicine, Detroit, MI, USA.
Gruber
Scott A
SA
El-Amm
Jose M
JM
Garnick
James
J
West
Miguel S
MS
Granger
Darla K
DK
Sillix
Dale H
DH
Migdal
Stephen D
SD
Haririan
Abdolreza
A
D001741:Black or African American; D000799:Angioedema / Q000139:chemically induced*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D011182:Postoperative Care; D019233:Retreatment; D020123:Sirolimus / Q000009:adverse effects*; D014184:Transplantation, Homologous
D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D020123:Sirolimus