Angioedema in renal transplant recipients on sirolimus.
BACKGROUND
Most drug-associated angioedemas are induced by angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, or nonsteroidal anti-inflammatory drugs. Recently, the responsibility of immunosuppressive agents given to transplant recipients in the development of angioedema has been discussed.


OBJECTIVE
To describe, in detail, angioedema episodes in renal transplant recipients (RTRs) on sirolimus.


METHODS
A cross-sectional study in a university hospital. Eighty consecutive RTRs on sirolimus were studied.


RESULTS
Angioedema without urticaria occurred a mean of 5 times in 12/80 (15%) RTRs taking sirolimus. It was predominantly located on the face (83%), with mucous membrane involvement in 7 (58%) patients, and was life threatening in 1. Another putative cofactor for angioedema without urticaria was identified in 9 (75%) patients: drugs (n=8), food allergy or physical activity (n=3). Tacrolimus intake was significantly associated with sirolimus-associated angioedema.


CONCLUSIONS
Our results suggested a causal relationship between sirolimus and angioedema in RTRs.
Mahé
Emmanuel
E
Department of Dermatology, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France. emmanuel.mahe@apr.aphp.fr
Morelon
Emmanuel
E
Lechaton
Sophie
S
Kreis
Henri
H
de Prost
Yves
Y
Bodemer
Christine
C
D000799:Angioedema / Q000139:chemically induced*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005148:Facial Dermatoses / Q000139:chemically induced; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D020123:Sirolimus / Q000009:adverse effects*
D007166:Immunosuppressive Agents; D020123:Sirolimus