TY - JOUR
T1 - Sirolimus induced granulomatous interstitial pneumonitis
AU - Ussavarungsi, Kamonpun
AU - Elsanjak, Abdelaziz
AU - Laski, Melvin
AU - Raj, Rishi
AU - Nugent, Kenneth
PY - 2012
Y1 - 2012
N2 - Objectives: Report a case of sirolimus induced granulomatous pneumonitis. Background: Sirolimus is used in clinical transplantation as an immunosuppressive agent. Pulmonary toxicity does occur, but only a few cases of sirolimus associated granulomatous interstitial pneumonitis have been reported. Methods: Case report and literature review. Results: This 53-year-old woman with ESRD from polycystic kidney disease status post deceased donor kidney transplantation presented with fever, progressive dyspnea, and hypoxia for two weeks. She had been switched to sirolimus two months before admission. A CT scan of the chest revealed bilateral ill-defined patchy ground glass opacities. Extensive investigations were negative for infection. Video-assisted thoracoscopic biopsy showed granulomatous interstitial pneumonitis. Her symptoms and infiltrates resolved after sirolimus discontinuation and corticosteroid treatment. Conclusions: Drugs induced pneumonitis should always be considered in transplant patients after infectious or other etiologies have been excluded. Sirolimus can cause granulomatous infiltrates in the lung possibly secondary to T-cell mediated hypersensitivity.
AB - Objectives: Report a case of sirolimus induced granulomatous pneumonitis. Background: Sirolimus is used in clinical transplantation as an immunosuppressive agent. Pulmonary toxicity does occur, but only a few cases of sirolimus associated granulomatous interstitial pneumonitis have been reported. Methods: Case report and literature review. Results: This 53-year-old woman with ESRD from polycystic kidney disease status post deceased donor kidney transplantation presented with fever, progressive dyspnea, and hypoxia for two weeks. She had been switched to sirolimus two months before admission. A CT scan of the chest revealed bilateral ill-defined patchy ground glass opacities. Extensive investigations were negative for infection. Video-assisted thoracoscopic biopsy showed granulomatous interstitial pneumonitis. Her symptoms and infiltrates resolved after sirolimus discontinuation and corticosteroid treatment. Conclusions: Drugs induced pneumonitis should always be considered in transplant patients after infectious or other etiologies have been excluded. Sirolimus can cause granulomatous infiltrates in the lung possibly secondary to T-cell mediated hypersensitivity.
KW - Granulomatous interstitial pneumonitis
KW - Interstitial pneumonitis
KW - Pulmonary toxicity
KW - Renal transplantation
KW - Sirolimus
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U2 - 10.1016/j.rmcr.2012.09.002
DO - 10.1016/j.rmcr.2012.09.002
M3 - Article
C2 - 26029599
AN - SCOPUS:84868446236
SN - 2213-0071
VL - 7
SP - 8
EP - 11
JO - Respiratory Medicine Case Reports
JF - Respiratory Medicine Case Reports
IS - 1
ER -