title: Sirolimus-induced alveolar hemorrhage.
abstract: Sirolimus is a well-known, potent immunosuppressant that is widely used in solid-organ transplantation, but it is not without potential side effects. A rare but devastating adverse effect is sirolimus-associated pulmonary toxicity. We report a case of sirolimus-induced diffuse alveolar hemorrhage confirmed by bronchoscopic findings (after other possible etiologies were ruled out) and by clinical and radiographic resolution of the pulmonary signs and symptoms a few days after sirolimus administration was stopped. This case and the existing literature on this topic suggest that sirolimus-induced pulmonary toxicity should be suspected in any patient taking immunosuppressants and who develops unexplained pulmonary symptoms.
authors.affiliation: Department of Cardiology, Division of Heart Failure/Cardiac Transplantation, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA. wkhalife@yahoo.com
authors.forename: Wissam I
authors.initials: WI
authors.lastname: Khalife
authors.forename: Polonca
authors.initials: P
authors.lastname: Kogoj
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
mesh_terms: D009202:Cardiomyopathies / Q000601:surgery*; D003937:Diagnosis, Differential; D016027:Heart Transplantation / Q000276:immunology*; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011650:Pulmonary Alveoli / Q000098:blood supply*; D020123:Sirolimus / Q000009:adverse effects*
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus