title: [Sirolimus associated pneumonitis in a hematopoietic stem cell transplant patient].
abstract: OBJECTIVE
  Sirolimus (SR) is a lipophilic macrocytic lactone with immunosuppressive properties (mTOR inhibitor) commonly used in solid organ transplantation and recently introduced in the prophylaxis and treatment of graft-versus-host disease. Its numerous side effects include: hyperlipidemia, arthralgias, noncardiac peripheral edema, thrombotic microangiopathy and interstitial pneumonitis. SR-associated pneumonitis is a rare but potentially serious complication due to its increasing utilization in transplant patients.
  
  
  METHODS
  We report the case of a patient undergoing hematopoietic stem cell transplantation with severe respiratory distress and SR therapy.
  
  
  RESULTS
  Microbiological tests were all negative and other complications related to transplantation were discarded. The chest computed tomography of high-resolution showed pneumonitis. The SR therapy was interrupted and treatment was started with steroids with resolution of symptoms.
  
  
  CONCLUSIONS
  SR associated pneumonitis is a potentially fatal side effect. In patients treated with SR and respiratory failure, we must suspect this complication because early recognition along with drug discontinuation and steroid treatment is essential to reverse this complication.
authors.affiliation: Servicio de Hematología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: Estefanía
authors.initials: E
authors.lastname: García
authors.affiliation: Servicio de Hematología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: Diana
authors.initials: D
authors.lastname: Buenasmañanas
authors.affiliation: Servicio de Hematología, Hospital Universitario Reina Sofía, Córdoba, España.
authors.forename: Carmen
authors.initials: C
authors.lastname: Martín
authors.affiliation: Servicio de Hematología, Hospital Universitario Reina Sofía, Córdoba, España. Electronic address: rrojashurs@hotmail.com.
authors.forename: Rafael
authors.initials: R
authors.lastname: Rojas
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010102:Oxygen Inhalation Therapy; D011014:Pneumonia / Q000139:chemically induced* / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D020123:Sirolimus / Q000009:adverse effects* / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D020123:Sirolimus
keywords: Hematopoietic stem cell transplant; Neumonitis y toxicidad pulmonar; Pneumonitis and pulmonary toxicity; Sirolimus; Trasplante de progenitores hematopoyéticos