title: Cardiac tamponade in a pediatric renal transplant recipient on sirolimus therapy.
abstract: Because of its lack of nephrotoxicity, the use of sirolimus, as an immunosuppressive agent, has increased considerably in solid-organ transplant (Tx) recipients. With its increased use, Tx professionals are encountering a variety of previously unreported side-effects such as angioedema and interstitial pneumonitis. We describe here the case of a pediatric renal Tx recipient who, while receiving sirolimus, developed a large pericardial effusion requiring pericardiocentesis. An extensive workup for an infectious etiology was performed; the only positive result was isolation of adenovirus type 2 from the patient's stool specimen. Following sirolimus dose reduction this child's effusion stabilized and has not recurred. The purpose of this report is to advise health-care professionals caring for Tx recipients about this potentially life-threatening complication associated with sirolimus. The role of adenovirus, if any, in contributing to the development of our patient's pericardial effusion is discussed herein.
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology and Section of Pediatric Nephrology, University of California Davis Children's Hospital, Sacramento, CA 95817, USA.
authors.forename: Uyen
authors.initials: U
authors.lastname: Truong
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Moon-Grady
authors.forename: Lavjay
authors.initials: L
authors.lastname: Butani
mesh_terms: D002305:Cardiac Tamponade / Q000139:chemically induced*; D002675:Child, Preschool; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D020123:Sirolimus / Q000009:adverse effects*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus