[Pulmonary manifestations associated with immunosuppressive treatments used in transplantation and autoimmune diseases].
Immunosuppressive agents may cause a number of adverse events and lead to an increased susceptibility to infections. In addition, these agents may increase the risk to develop malignancies. The two immunosuppressive agents that are more frequently responsible for interstitial lung disease (ILD) are methotrexate and sirolimus. Although immunosuppressants expose to an increased risk to develop pyogenic bacterial infections, the major risk in these patients is associated with opportunistic infections, mainly in patients treated with ciclosporin, tacrolimus, sirolimus or combined therapy. Bronchoscopy and bronchoalveolar lavage are mandatory in this setting in order to make a microbiological and/or pathological diagnosis and adapt treatment.
Pestre
Vincent
V
Université Paris-Descartes, faculté de médecine, pôle de médecine interne, hôpital Cochin, Assistance publique-Hôpitaux de Paris (AP-HP), 75679 Paris, France.
Mouthon
Luc
L
D000911:Antibodies, Monoclonal / Q000009:adverse effects; D058846:Antibodies, Monoclonal, Murine-Derived; D001327:Autoimmune Diseases / Q000188:drug therapy*; D016572:Cyclosporine / Q000009:adverse effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D008171:Lung Diseases / Q000139:chemically induced*; D016377:Organ Transplantation; D000069283:Rituximab; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha; D000069283:Rituximab; D016572:Cyclosporine