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Related Experiment Video

Updated: Jul 8, 2026

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
04:44

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Published on: June 16, 2020

Sympathetic dystrophy associated with sirolimus therapy.

Miguel Gonzalez Molina1, Fritz Diekmann, Dolores Burgos

  • 1Division of Nephrology (Renal Transplant Unit) and Surgery, Hospital Universitario Carlos Haya, Malaga, Spain. mgonmol@yahoo.es

Transplantation
|January 24, 2008
PubMed
Summary

Sirolimus therapy may cause reflex sympathetic dystrophy syndrome (RSDS) in kidney transplant patients. Symptoms like leg pain and skin redness improved with treatment, suggesting a link between sirolimus and RSDS.

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Last Updated: Jul 8, 2026

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
04:44

Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease

Published on: June 16, 2020

Area of Science:

  • Nephrology
  • Immunology
  • Pharmacology

Background:

  • Reflex sympathetic dystrophy syndrome (RSDS) previously linked to calcineurin inhibitors in organ transplant recipients.
  • Limited data exists on RSDS in patients treated with other immunosuppressants.

Purpose of the Study:

  • To investigate the potential association between sirolimus use and the development of RSDS in renal transplant recipients.
  • To describe the clinical presentation, diagnosis, and treatment outcomes of RSDS in this patient population.

Main Methods:

  • Retrospective analysis of 393 renal transplant patients treated with sirolimus.
  • Clinical data collection including symptoms, onset, serum creatinine, and bone scintigraphy.
  • Evaluation of treatment response to calcitriol, nifedipine, calcitonin, or sirolimus withdrawal.

Main Results:

  • Nine out of 393 patients (2.3%) developed RSDS, characterized by leg pain and cutaneous erythema.
  • Symptom onset occurred 1-6 months post-transplantation.
  • Bone scintigraphy showed increased 99mTc pyrophosphate uptake in all affected patients.

Conclusions:

  • Sirolimus therapy may induce RSDS in renal transplant recipients.
  • Treatment with calcitriol, with or without other medications, led to symptom remission.
  • Discontinuation of sirolimus was effective in one case, further supporting the link.