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Sirolimus-Associated Pruritus: Case Report and Review
Joyce Y Cheng1, Philip R Cohen2
1Department of Internal Medicine, University of California, San Diego.
Cureus
|August 29, 2017
Summary
Sirolimus, an immunosuppressant, can cause severe, persistent pruritus (itching) in transplant patients. Dose reduction or switching to everolimus may offer relief, but discontinuation might be necessary.
Area of Science:
- Immunology
- Pharmacology
- Dermatology
Background:
- Sirolimus is a vital immunosuppressant medication used to prevent organ rejection in transplant recipients.
- Managing adverse drug reactions is crucial for long-term transplant success and patient quality of life.
Observation:
- A 67-year-old heart transplant patient developed severe, progressive pruritus six months after initiating sirolimus therapy.
- The pruritus affected distal extremities, face, and earlobes, improving upon temporary sirolimus cessation.
Findings:
- Systemic pruritus is identified as a rare but significant adverse event associated with sirolimus use.
- This adverse event can manifest in heart and liver transplant patients, typically months post-transplant, and may be persistent.
Implications:
- Dose reduction of sirolimus may alleviate pruritus symptoms.
- Discontinuation of sirolimus or switching to alternative immunosuppressants like everolimus may be required for complete symptom resolution.
