title: Pulmonary alveolar proteinosis in a kidney transplant: a rare complication of sirolimus.
abstract: Pulmonary alveolar proteinosis (PAP) has been associated with the immunosuppressant sirolimus in transplant patients. PAP is a progressive lung disease characterized by the accumulation of surfactant-like material in the lungs leading to decreased pulmonary function with shortness of breath and cough as common symptoms. We report a rare case of sirolimus-associated PAP in a kidney transplant recipient with a history of end-stage renal disease secondary to haemolytic uraemic syndrome (HUS) and review of the literature. Discontinuation of sirolimus and initiation of tacrolimus led to resolution of PAP without recurrence of HUS.
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX, USA. hkadikoy@gmail.com
authors.forename: Huseyin
authors.initials: H
authors.lastname: Kadikoy
authors.forename: Michael
authors.initials: M
authors.lastname: Paolini
authors.forename: Katafan
authors.initials: K
authors.lastname: Achkar
authors.forename: Wadi
authors.initials: W
authors.lastname: Suki
authors.forename: A Osama
authors.initials: AO
authors.lastname: Gaber
authors.forename: Nabeel
authors.initials: N
authors.lastname: Anwar
authors.forename: Abdallah
authors.initials: A
authors.lastname: Jeroudi
authors.forename: Roberto
authors.initials: R
authors.lastname: Barrios
authors.forename: Abdul
authors.initials: A
authors.lastname: Abdellatif
mesh_terms: D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D006463:Hemolytic-Uremic Syndrome / Q000150:complications; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000601:surgery*; D016030:Kidney Transplantation / Q000276:immunology; D008875:Middle Aged; D011649:Pulmonary Alveolar Proteinosis / Q000139:chemically induced* / Q000175:diagnosis*; D012008:Recurrence; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus