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Mayo Clinic proceedings · Apr 2004
Review Case ReportsSirolimus-associated diffuse alveolar hemorrhage.
- Nicholas E Vlahakis, Otis B Rickman, and Timothy Morgenthaler.
- Division of Pulmonary and Critical Care Medicine and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA. vlahakis.nicholas@mayo.edu
- Mayo Clin. Proc. 2004 Apr 1;79(4):541-5.
AbstractSirolimus is an immunosuppressive medication used in transplant recipients. To our knowledge, we describe the third reported case of alveolar hemorrhage in association with sirolimus. Fever, dyspnea, hemoptysis, and lung infiltrates resolved rapidly with cessation of sirolimus therapy both initially and after reinstitution of the drug. Unlike previous reports, our patient had no evidence of lymphocytic alveolitis but rather marked macrophage hemosiderosis, suggesting that sirolimus pulmonary toxicity may manifest through 2 separate mechanisms. Our case highlights an uncommon but potentially lethal manifestation of sirolimus pulmonary toxicity.
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