Everolimus induced pneumonitis in a lung transplant recipient

Everolimus is a mechanistic target of rapamycin inhibitor used for the treatment of various cancers and prevention of allograft rejection in solid organ transplantation. We present a case of a lung transplant recipient on everolimus who was admitted with generalized weakness, hypoxia and new onset bilateral pulmonary infiltrates on imaging. Extensive workup revealed no infectious etiology and high levels of serum everolimus levels. Her condition deteriorated over the hospital course with symptoms and signs of systemic everolimus toxicity. She was treated with high-dose steroids with significant improvement. Follow-up imaging showed resolution of infiltrates. Everolimus induced pneumonitis is seldom reported in the lung transplant literature. It is important to recognize early signs of toxicity to intervene and preserve the lung allograft.