Sirolimus induced granulomatous interstitial pneumonitis

Kamonpun Ussavarungsi; Abdelaziz Elsanjak; Melvin Laski; Rishi Raj; Kenneth Nugent

doi:10.1016/j.rmcr.2012.09.002

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Sirolimus induced granulomatous interstitial pneumonitis

Journal article

Open access

Peer reviewed

Sirolimus induced granulomatous interstitial pneumonitis

Kamonpun Ussavarungsi, Abdelaziz Elsanjak, Melvin Laski, Rishi Raj and Kenneth Nugent

Respiratory medicine case reports, Vol.7(1), pp.8-11

2012

DOI: 10.1016/j.rmcr.2012.09.002

PMCID: PMC3920426

PMID: 26029599

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Abstract

Report a case of sirolimus induced granulomatous pneumonitis. Sirolimus is used in clinical transplantation as an immunosuppressive agent. Pulmonary toxicity does occur, but only a few cases of sirolimus associated granulomatous interstitial pneumonitis have been reported. Case report and literature review. This 53-year-old woman with ESRD from polycystic kidney disease status post deceased donor kidney transplantation presented with fever, progressive dyspnea, and hypoxia for two weeks. She had been switched to sirolimus two months before admission. A CT scan of the chest revealed bilateral ill-defined patchy ground glass opacities. Extensive investigations were negative for infection. Video-assisted thoracoscopic biopsy showed granulomatous interstitial pneumonitis. Her symptoms and infiltrates resolved after sirolimus discontinuation and corticosteroid treatment. Drugs induced pneumonitis should always be considered in transplant patients after infectious or other etiologies have been excluded. Sirolimus can cause granulomatous infiltrates in the lung possibly secondary to T-cell mediated hypersensitivity.

Interstitial pneumonitis

Renal transplantation

Granulomatous interstitial pneumonitis

Sirolimus

Pulmonary toxicity

Details

Title: Subtitle: Sirolimus induced granulomatous interstitial pneumonitis
Creators: Kamonpun Ussavarungsi - Department of Internal Medicine, Texas Tech University Health Science Center, 3601 4th Street, Lubbock, TX 79430, United States
Abdelaziz Elsanjak - Department of Internal Medicine, Texas Tech University Health Science Center, 3601 4th Street, Lubbock, TX 79430, United States
Melvin Laski - Department of Internal Medicine, Texas Tech University Health Science Center, 3601 4th Street, Lubbock, TX 79430, United States
Rishi Raj - Department of Internal Medicine, Texas Tech University Health Science Center, 3601 4th Street, Lubbock, TX 79430, United States
Kenneth Nugent - Department of Internal Medicine, Texas Tech University Health Science Center, 3601 4th Street, Lubbock, TX 79430, United States
Resource Type: Journal article
Publication Details: Respiratory medicine case reports, Vol.7(1), pp.8-11
DOI: 10.1016/j.rmcr.2012.09.002
PMID: 26029599
PMCID: PMC3920426
NLM abbreviation: Respir Med Case Rep
ISSN: 2213-0071
eISSN: 2213-0071
Language: English
Date published: 2012
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984094565002771

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