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Immunosuppressive therapy with everolimus can be associated with potentially life-threatening lingual angioedema

Uwe Fuchs1, Armin Zittermann, Heiner K Berthold

  • 1Heart Center Northrhine-Westfalia, Department of Cardio-Thoracic Surgery, Ruhr University of Bochum, D-32545 Bad Oeynhausen, Germany. ufuchs@hdz-nrw.de

Transplantation
|April 26, 2005
PubMed

Everolimus has recently received approval for immunosuppressive therapy in heart transplant recipients in Austria and Germany. At our heart center we have treated 114 patients with everolimus since January 2004. Here we describe 6 cases of lingual angioedema (corresponding to 5.3% of the patients). Symptoms occurred within 2 to 41 days after initiation of therapy. In 5 out of the 6 patients, lingual angioedema disappeared with anti-allergic treatment alone. However, in one patient, two severe recurrent episodes of lingual angioedema occurred so that therapy had to be discontinued. We conclude that the potentially life-threatening condition of lingual angioedema should be considered a severe drug reaction after initiation of everolimus therapy in heart transplant recipients.

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