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[Lung toxicity induced by rapamycin].

C Damas1, A Oliveira, A Morais

  • 1Serviço de Pneumologia, Hospital de São João, Alameda Hernâni Monteiro, 4200-451 Porto.

Revista Portuguesa De Pneumologia
|February 16, 2007
PubMed
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Sirolimus can cause drug-induced lung diseases (DILD) in transplant patients, presenting diverse symptoms and HRCT findings. Early drug withdrawal led to significant improvement, suggesting varied sirolimus-related lung injury mechanisms.

Area of Science:

  • Pulmonology
  • Pharmacology
  • Transplantation Medicine

Background:

  • Drug-induced lung diseases (DILD) represent a growing cause of morbidity.
  • Sirolimus, an immunosuppressant, is increasingly used in solid organ transplantation.
  • Pulmonary toxicity is a recognized complication of sirolimus therapy.

Observation:

  • Four transplant recipients (3 male, 1 female; ages 46-71) developed lung issues.
  • Patients presented with fever, dyspnea, and productive cough.
  • HRCT scans revealed diffuse pulmonary infiltrates with basal predominance.

Findings:

  • Bronchoalveolar lavage (BAL) showed lymphocytic alveolitis in 3 cases, with varying CD4/CD8 ratios.
  • Two patients had neutrophilia, and one experienced alveolar hemorrhage.

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  • Pulmonary infections were excluded; drug suspension resulted in clinical improvement.

    • Implications:

    • Sirolimus-induced lung injury can manifest with diverse clinical and BAL findings.
    • These variations may indicate distinct underlying pathophysiological processes.
    • Further research is needed to elucidate the mechanisms of sirolimus pulmonary toxicity.