Sirolimus-induced lymphoedema.
Sirolimus is an inhibitor of the mammalian target of rapamycin (mTOR), used as an immunosuppressant for solid-organ transplant recipients and patients with autoimmune disorders. We report a case of lymphoedema, a rare complication of sirolimus, and discuss the mechanism of drug action, the adverse effects and the challenges of treating a kidney transplant recipient with this complication in a resource-limited environment. Lymphoedema is a rare complication of sirolimus, and the mechanisms are not completely understood; however, early recognition can prevent permanent disfiguration. This case highlights the need for early recognition of adverse drug effects and further research into their pathophysiology and management.
School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, South Africa; Division of Nephrology, Chris Hani Baragwanath Academic Hospital, South Africa. kagiso.motse@gmail.com.
Kagiso G
KG
Motse
Mduduzi J
MJ
Mashabane
D000328:Adult; D057915:Drug Substitution / Q000379:methods; D006084:Graft Rejection / Q000209:etiology / Q000276:immunology / Q000517:prevention & control*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D007676:Kidney Failure, Chronic / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D035002:Lower Extremity / Q000473:pathology / Q000503:physiopathology; D008209:Lymphedema / Q000139:chemically induced / Q000175:diagnosis / Q000276:immunology / Q000628:therapy; D008220:Lymphography / Q000379:methods; D008297:Male; D011241:Prednisone / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D058570:TOR Serine-Threonine Kinases / Q000037:antagonists & inhibitors / Q000276:immunology; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods
D007166:Immunosuppressive Agents; C546842:MTOR protein, human; D058570:TOR Serine-Threonine Kinases; D011241:Prednisone; D020123:Sirolimus