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Sirolimus-Induced Diffuse Alveolar Hemorrhage: A Case Report.

Baran Balcan1, Ergun Simsek, Aylin O Ugurlu

  • 1Departments of 1Pulmonary Medicine, 2Nephrology, and 3Pathology, Faculty of Medicine, Baskent University, Istanbul, Turkey.

American Journal of Therapeutics
|February 6, 2016
PubMed
Summary

Sirolimus, a drug used in transplants, can cause lung damage like diffuse alveolar hemorrhage. Discontinuing sirolimus and using steroids led to a full recovery of pulmonary function in a renal transplant patient.

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Area of Science:

  • Immunology
  • Pulmonology
  • Pharmacology

Background:

  • Sirolimus (rapamycin) is a protein kinase that inhibits T and B cell proliferation.
  • Sirolimus is associated with various pulmonary side effects, including cryptogenic organizing pneumonia and diffuse alveolar hemorrhage.

Observation:

  • A 33-year-old female renal transplant recipient presented with diffuse alveolar hemorrhage.
  • Diagnosis was confirmed through clinical, radiological, histological, and pathological evaluations.

Findings:

  • Discontinuation of sirolimus resulted in clinical improvement and better radiological images.
  • A 6-month course of gradually tapered steroid therapy led to full recovery of pulmonary function.

Implications:

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  • This case highlights the potential pulmonary toxicity of sirolimus.
  • Early diagnosis and management, including drug withdrawal and corticosteroid therapy, are crucial for favorable outcomes in sirolimus-induced lung injury.