This journal only 2012, Number 3 Neumol Cir Torax 2012; 71 (3) Sirolimus related pneumonitis in heart transplant patients. Report of two cases Zetina-Tun HJ, Careaga-Reyna G, Lezama-Urtecho CA, Galván-Díaz J, Cerda-Belmont GA Full text How to cite this article Language: Spanish References: 20 Page: 240-243 PDF size: 146.38 Kb. Key words: Sirolimus, heart transplantation, pneumonitis, immunosuppressive therapy. ABSTRACT Background: Immunosuppressive therapy for heart transplantation has been evolved. However, the immunosuppressive drugs may produce serious adverse effects as pneumonitis with the use of sirolimus. Case reports: Two male heart transplant recipients age 40 and 58 years-old, were accepted in our service with fever, rash and pneumonitis. The diagnosis of pneumonitis associated to the use of sirolimus was made via exclusion of other etiological possibilities, and the drug was retired of the immunosuppressive therapy. The patients, immediately improves their clinical condition. Conclusion: It was concluded that sirolimus related pneumonitis is a serious complication, and this condition must be suspected in transplant recipients, and diagnosis could be made with the exclusion of other etiological causes. When the sirolimus administration is suspended, the patient immediately improves clinically. REFERENCES Kouchoukos NT, Blackstone EH, Doty DB, Hanley FL, Karp RB, editors. Heart failure. In: Kirklin/Barrat-Boyes Cardiac surgery. 3rd ed. Vol 2. Churchill-Livingstone, USA: Elsevier; 2003.p.1724-1777. MacDonald AS, RAPAMUNE Global Study Group. A worldwide, phase III, randomized, controlled, safety and efficacy study of a sirolimus/cyclosporine regimen for prevention of acute rejection in recipients of primary mismatched renal allografts. Transplantation 2001;71:271-280. Jokinen JJ, Tikkanen J, Kukkonen S, et al. Natural course and risk factors for impaired renal function during the first year after heart transplantation. J Heart Lung Transplant 2010;29:633-640. Groth CG, Bäckman L, Morales JM, et al. Sirolimus (rapamycin)-based therapy in human renal transplantation: similar efficacy and different toxicity compared with cyclosporine. Sirolimus European Renal Transplant Study Group. Transplantation 1999;67:1036-1042. Kreis H, Oberbauer R, Campistol JM, et al. Long-term benefits with sirolimus-based therapy after early cyclosporine with drawal. J Am Soc Nephrol 2004;15:809-817. Kahan BD, Camardo JS. Rapamycin: clinical results and future opportunities. Transplantation 2001;72:1181-1193. Dupont P, Warrens AN. The evolving role of sirolimus in renal transplantation. QJM 2003;96:401-409. Kreis H, Cisterne JM, Land W, et al. Sirolimus in association with mycophenolate mofetil induction for the prevention of acute graft rejection in renal allograft recipients. Transplantation 2000;69:1252-1260. Champion L, Stern M, lsraël-Biet D, et al. Brief communication: sirolimus-associated pneumonitis: 24 cases in renal transplant recipients. Ann Intern Med 2006;144:505-509. Pham PT, Pham PC, Danovitch GM, et al. Sirolimus-associated pulmonary toxicity. Transplantation 2004;77:1215-1220. Mahalati K, Murphy DM, West ML. Bronchiolitis obliterans and organizing pneumonia in renal transplant recipients. Transplantation 2000;69:1531-1535. Lennon A, Finan K, FitzGerald MX, McCormick PA. Interstitial pneumonitis associated with sirolimus (rapamycin) therapy after liver transplantation. Transplantation 2001;72:1166-1167. Morelon E, Stern M, Israël-Biet D, et al. Characteristics of sirolimus-associated interstitial pneumonitis in renal transplant patients. Transplantation 2001;72:787-790. Martínez M, González-Roncero FM, López M, et al. Neumonitis intersticial asociada al uso de sirolimus en un trasplantado renal: un caso clínico. Nefrología 2004;24(Suppl 3):7-10. Jiménez-Pérez M, Olmedo-Martín R, Marín-García D, Lozano-Rey JM, de la Cruz-Lombardo J, Rodrigo-López JM. Toxicidad pulmonar asociada a sirolimus en el trasplante hepático. Gastroenterol Hepatol 2006;29:616-618. Chhajed PN, Dickenmann M, Bubendorf L, Mayr M, Steiger J, Tamm M. Patterns of pulmonary complications associated with sirolimus. Respiration 2006;73:367-374. Lindenfeld JA, Simon SF, Zamora MR, et al. BOOP is common in cardiac transplant recipients switched from a calcineurin inhibitor to sirolimus. Am J Transplant 2005;5:1392-1396. Weiner SM, Sellin L, Vonend O, et al. Pneumonitis associated with sirolimus: clinical characteristics, risk factors and outcome-a single-centre experience and review of the literature. Nephrol Dial Transplant 2007;22:3631-3637. Singer SJ, Tiernan R, Sullivan EJ. Interstitial pneumonitis associated with sirolimus therapy in renal-transplant recipients. N Engl J Med 2000;343:1815-1816. Digon BJ 3rd, Rother KI, Hirshberg B, Harlan DM. Sirolimus induced interstitial pneumonitis in an islet transplant recipient. Diabetes Care 2003;26:3191.