Everolimus-associated pneumonitis in 3 heart transplant recipients.
Although pulmonary toxicity from sirolimus is well recognized, the biochemically homologous everolimus has until recently been thought to be free from this side effect. Emerging evidence suggests an association between high-dose everolimus and symptomatic pneumonitis. Toxicity at typical immunosuppressive doses has also been described. In support of these observations, we report the occurrence of clinical pneumonitis in 3 patients in association with everolimus therapy after heart transplantation in the absence of other causative factors. Typical onset consisted of dyspnea, hypoxemia, and bilateral diffuse pulmonary infiltrates beginning between 2 weeks and 6 months after commencement of the drug. Although uncommon, everolimus may cause pneumonitis and should be considered in the differential diagnosis of pulmonary infiltrates and hypoxemia in an appropriate clinical setting.
Otton
James
J
Cardiopulmonary Transplant Unit, St. Vincent's Hospital Sydney, New South Wales, Australia. jotton@gmail.com
Hayward
Christopher S
CS
Keogh
Anne M
AM
Glanville
Allan R
AR
Macdonald
Peter S
PS
D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000068338:Everolimus; D016027:Heart Transplantation / Q000276:immunology*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000139:chemically induced* / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives*; D014057:Tomography, X-Ray Computed
D000889:Anti-Arrhythmia Agents; D007166:Immunosuppressive Agents; D000068338:Everolimus; D000638:Amiodarone; D020123:Sirolimus