title: [Sirolimus-induced lymphedema in a kidney-transplant recipient: Partial recovery after changeover to tacrolimus].
abstract: BACKGROUND
  Lymphedema induced by mTOR inhibitors is a side-effect rarely reported to date.
  
  
  METHODS
  Long-lasting bilateral lower-limb lymphedema with left predominance developed in a 71-year-old stable renal transplant recipient after 40 months of sirolimus treatment. Although no change in lymphedema was observed after 21 months despite dosage reduced, it improved markedly after changeover to tacrolimus.
  
  
  CONCLUSIONS
  Regardless of the individual drug, mTOR inhibitors can cause lymphedema. This effect may be countered through substitution with tacrolimus.
  
  
  CONCLUSIONS
  Physicians should be aware of lymphedema as a side-effect of mTOR inhibitors. It can be improved by substitution with tacrolimus. However, early withdrawal of mTOR inhibitors is recommended before irreversible lymphedema occurs.
authors: Service de dermatologie, hôpital Bichat, APHP, université Paris-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; Service de dermatologie, King-Abdulaziz university, Jeddah, Arabie Saoudite.
authors: M
authors: M
authors: Al Gain
authors: Service de dermatologie, hôpital Bichat, APHP, université Paris-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
authors: B
authors: B
authors: Crickx
authors: Service de dermatologie, hôpital Bichat, APHP, université Paris-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
authors: C
authors: C
authors: Bejar
authors: Service de dermatologie, hôpital Bichat, APHP, université Paris-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
authors: L
authors: L
authors: Chen
authors: Service de néphrologie, hôpital Bichat, APHP, université Paris-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
authors: L
authors: L
authors: Azeroual
authors: Service d'anatomopathologie, hôpital Bichat, APHP, université Paris-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France.
authors: E
authors: E
authors: Marinho
authors: Service de dermatologie, hôpital Bichat, APHP, université Paris-Diderot, 46, rue Henri-Huchard, 75877 Paris cedex 18, France. Electronic address: vincent.descamps@bch.aphp.fr.
authors: V
authors: V
authors: Descamps
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D008209:Lymphedema / Q000139:chemically induced*; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use; D016559:Tacrolimus / Q000627:therapeutic use*; D066027:Transplant Recipients
chemical_list: D007166:Immunosuppressive Agents; D020123:Sirolimus; D016559:Tacrolimus
keywords: Inhibiteur; Lymphedema; Lymphœdème; Sirolimus; Tacrolimus; de mTOR; mTOR inhibitor