31 December 2012
Early everolimus-induced pneumonitis in a renal transplant recipient: A case reportKatarzyna SułkowskaBCDEF, Piotr PalczewskiBCDEF, Dorota Miszewska-SzyszkowskaBEF, Magdalena DurlikAD, Marek GołębiowskiACD, Piotr MałkowskiAD
Ann Transplant 2012; 17(4): 144-148
Background: Everolimus is a derivative of sirolimus, and is considered to be free of the latter’s pulmonary toxicity. Recently, a few cases of everolimus-induced lung injury have been reported. Early recognition of drug-induced lung disease is important because it can be reversed if appropriate therapy is instituted soon after the onset of symptoms.
Case Report: We present the case of an everolimus-induced pneumonitis in a renal transplant recipient, which occurred as early as on the 5th day after everolimus introduction.
Shortly after the transplant procedure, the patient presented with typical symptoms of pulmonary infection. Chest radiography and computed tomography showed bilateral patchy lung infiltrates with peribronchial distribution that were suggestive of bacterial pneumonia. However, there was no improvement with empiric antibiotic treatment. Repeated cultures from the blood, sputum, and broncho-alveolar lavage (BAL) also were negative. Tuberculosis, Pneumocystis jiroveci, and Cytomegalovirus infections were excluded. A transbronchial lung biopsy performed 9 days after the onset of symptoms revealed mild nonspecific inflammation with a fibrotic component in the bronchial walls. Withdrawal of everolimus on the third day of hospitalization and after 8 days of its usage resulted in quick clinical recovery and resolution of radiological abnormalities within 1 month.
Conclusions: Diagnosis of drug-induced pulmonary toxicity is difficult because it is essentially a diagnosis of exclusion. Lack of response to empiric antibiotic treatment and an imaging pattern of organizing pneumonia should raise suspicion of everolimus-induced pneumonitis in patients undergoing therapy with this drug.
Keywords: Everolimus, pneumonitis, Transplantation
29 March 2023 : EditorialEditorial: Effective Direct-Acting Antiviral Treatments Support Global and National Programs to Eliminate H...
Med Sci Monit In Press; DOI: 10.12659/MSM.940519
06 December 2022 : Original articleChanges in Physical Activity Due to Fear of COVID-19 and Its Impact on Depression Among Post-Liver Transpla...
Ann Transplant 2022; 27:e938239
04 October 2022 : Original articleIncidence of COVID-19 and Identification of Possible Risk Factors Associated with COVID-19 in Acute Renal T...
Ann Transplant 2022; 27:e937688
12 April 2022 : Letter/CorrespondencePancreas Allograft Thrombosis as a Post-COVID-19 Complication in a Diabetic Patient After Pancreas Transpla...
Ann Transplant 2022; 27:e935863
27 Mar 2023 : Original articleOutcomes of Kidney Transplantation in Older Recipients
Ann Transplant In Press; DOI: 10.12659/AOT.938692
27 Mar 2023 : Original articleThe Incidence of Brain-Dead Donors Based on Screening and Management Led by Intensivists
Ann Transplant In Press; DOI: 10.12659/AOT.939521
22 Mar 2023 : Original articleEffect of Sodium Bicarbonate Ringer’s Solution on Intraoperative Blood Gas Analysis and Postoperative Recov...
Ann Transplant In Press; DOI: 10.12659/AOT.939097
17 Mar 2023 : Original articleConverting from Tenofovir Disoproxil Fumarate to Tenofovir Alafenamide in Patients with Hepatitis B Followi...
Ann Transplant In Press; DOI: 10.12659/AOT.938731
Most Viewed Current Articles
24 Aug 2021 : Review articleNormothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review articleRecurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
15 Mar 2022 : Case reportCombined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...
Ann Transplant 2022; 27:e935860