Everolimus-induced lymphedema in a renal transplant recipient: a case report.
The mammalian target of rapamycin inhibitors is commonly preferred for solid organs for transplantation. Although these drugs have various adverse effects, sirolimus-related lymphedema has been rarely reported. We report a case of lymphedema related to everolimus after a kidney transplant. A 60-year-old woman successfully received a deceased-donor kidney. Everolimus was added to the treatment in postoperative month 3 owing to other immunosuppressive drugs' adverse effects. Edema occurred first on her feet in the first year after the transplant. During 3 months' follow-up, with no immunosuppressive adjustment, the edema progressed. Diagnosis of lymphedema was established. Several weeks after discontinuing everolimus, the patient's lymphedema began to resolve itself and completely disappeared in 3 months. The mammalian target of rapamycin inhibitors rarely causes lymphedema by inhibiting different subtypes of vascular endothelial growth factors, which results in impaired lymphangiogenesis. While there are few reports about sirolimus-related lymphedema, this case represents the first everolimus-related case of lymphedema. Further studies are warranted to explain the underlying mechanisms.
Department of Nephrology and Rheumatology, Uludag University, Medical School, Bursa, Turkey. alpersoy@uludag.edu.tr
Alparslan
A
Ersoy
Nizameddin
N
Koca
D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000601:surgery*; D016030:Kidney Transplantation / Q000276:immunology*; D008209:Lymphedema / Q000139:chemically induced* / Q000000981:diagnostic imaging; D061305:Lymphoscintigraphy; D008875:Middle Aged; D020123:Sirolimus / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D014180:Transplantation; D016896:Treatment Outcome; D028761:Withholding Treatment
D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus