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Related Experiment Videos

Sirolimus-induced leukocytoclastic vasculitis.

Karen L Hardinger1, Lynn A Cornelius, Elbert P Trulock

  • 1Department of Pharmacy, Barnes-Jewish Hospital at Washington University, St. Louis, MO 63110, USA. klh2562@bjc.org.

Transplantation
|September 28, 2002
PubMed
Summary

Sirolimus, used to prevent organ rejection, can cause leukocytoclastic vasculitis, a skin condition. This case highlights the need to consider sirolimus as a potential cause of vasculitis in transplant patients.

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Area of Science:

  • Nephrology
  • Immunology
  • Dermatology

Background:

  • A cystic fibrosis patient with a history of lung and kidney transplants developed complications from immunosuppressive therapy.
  • The patient's regimen included cyclosporine, prednisone, and later sirolimus, after mycophenolate mofetil was discontinued.

Observation:

  • The patient presented with palpable purpura on the lower extremities.
  • The rash resolved upon sirolimus discontinuation and recurred upon rechallenge.

Findings:

  • Punch biopsy confirmed leukocytoclastic vasculitis with focal fibrinoid necrosis.
  • This suggests a causal link between sirolimus and the vasculitic reaction.

Implications:

  • Sirolimus should be considered a potential cause of cutaneous leukocytoclastic vasculitis.

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  • Clinicians should be aware of this adverse effect when managing immunosuppression in transplant recipients.