title: Interstitial pneumonitis in the transplant patient: consider sirolimus-associated pulmonary toxicity.
abstract: Interstitial pneumonia in a transplant patient can have a varied etiology. Sirolimus (Rapamycin; Rapamune) is a popularly used immunosuppressant in solid organ transplantation that has anecdotally been associated with pulmonary toxicity. Sirolimus-induced pulmonary toxicity consists of a range of syndromes that is characterized by the presence of organizing pneumonia, interstitial pneumonitis, pulmonary alveolar proteinosis, focal fibrosis, or by the presence of alveolar hemorrhage. Diagnosis can be challenging and is usually made by exclusion of other etiologies. In this report we present two cases of sirolimus-associated pulmonary toxicity with a review of the literature.
authors.affiliation: Tulane University, Department of Internal Medicine, New Orleans, USA.
authors.forename: Jacob
authors.initials: J
authors.lastname: Feagans
authors.forename: David
authors.initials: D
authors.lastname: Victor
authors.forename: Martin
authors.initials: M
authors.lastname: Moehlen
authors.forename: Sander S
authors.initials: SS
authors.lastname: Florman
authors.forename: Fredric
authors.initials: F
authors.lastname: Regenstein
authors.forename: Luis A
authors.initials: LA
authors.lastname: Balart
authors.forename: Shobha
authors.initials: S
authors.lastname: Joshi
authors.forename: Mary T
authors.initials: MT
authors.lastname: Killackey
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Slakey
authors.forename: Anil S
authors.initials: AS
authors.lastname: Paramesh
mesh_terms: D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D016031:Liver Transplantation / Q000276:immunology; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus