Immunosuppressive therapy with everolimus can be associated with potentially life-threatening lingual angioedema.
Everolimus has recently received approval for immunosuppressive therapy in heart transplant recipients in Austria and Germany. At our heart center we have treated 114 patients with everolimus since January 2004. Here we describe 6 cases of lingual angioedema (corresponding to 5.3% of the patients). Symptoms occurred within 2 to 41 days after initiation of therapy. In 5 out of the 6 patients, lingual angioedema disappeared with anti-allergic treatment alone. However, in one patient, two severe recurrent episodes of lingual angioedema occurred so that therapy had to be discontinued. We conclude that the potentially life-threatening condition of lingual angioedema should be considered a severe drug reaction after initiation of everolimus therapy in heart transplant recipients.
Fuchs
Uwe
U
Heart Center Northrhine-Westfalia, Department of Cardio-Thoracic Surgery, Ruhr University of Bochum, D-32545 Bad Oeynhausen, Germany. ufuchs@hdz-nrw.de
Zittermann
Armin
A
Berthold
Heiner K
HK
Tenderich
Gero
G
Deyerling
Karl W
KW
Minami
Kazutomo
K
Koerfer
Reiner
R
D000799:Angioedema / Q000139:chemically induced* / Q000473:pathology; D000068338:Everolimus; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects*; D020123:Sirolimus / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000494:pharmacology*
D000068338:Everolimus; D020123:Sirolimus