title: Immunosuppressive therapy with everolimus can be associated with potentially life-threatening lingual angioedema.
abstract: 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.
authors.affiliation: Heart Center Northrhine-Westfalia, Department of Cardio-Thoracic Surgery, Ruhr University of Bochum, D-32545 Bad Oeynhausen, Germany. ufuchs@hdz-nrw.de
authors.forename: Uwe
authors.initials: U
authors.lastname: Fuchs
authors.forename: Armin
authors.initials: A
authors.lastname: Zittermann
authors.forename: Heiner K
authors.initials: HK
authors.lastname: Berthold
authors.forename: Gero
authors.initials: G
authors.lastname: Tenderich
authors.forename: Karl W
authors.initials: KW
authors.lastname: Deyerling
authors.forename: Kazutomo
authors.initials: K
authors.lastname: Minami
authors.forename: Reiner
authors.initials: R
authors.lastname: Koerfer
mesh_terms: 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*
chemical_list: D000068338:Everolimus; D020123:Sirolimus