2013, Number 2
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Anales de Radiología México 2013; 12 (2)
Acinary bronchiolitis obliterans, induced by sirolimus, in post-liver transplant
Guerra-Meza CI, Ramírez-Aguilar M, Ávila-Armendáriz JA
Language: Spanish
References: 12
Page: 127-131
PDF size: 387.42 Kb.
ABSTRACT
It has been observed that with the use of sirolimus (rapamycin)
as an immunosuppressant in liver transplant there has also been
an increase in inexplicable interstitial pneumonitis. Pneumonitis
occurs after the drug is withdrawn but it has also manifested
after merely reducing the dose of sirolimus.
We present the case of a female patient age 56 years, with antecedent
of liver transplant, with unproductive cough followed
by progressive dyspnea evolving into dyspnea at rest; without
fever. In the high-resolution chest tomography we observed
extensive infiltrates in the form of ground glass distributed in
patches, in both fields, with predominance on the periphery of
both lungs and accompanied by thickening of the interlobular
septa. A bronchoscopy was performed with transbronchial biopsy
and the histopathologic diagnosis was: diffuse damage to
the pulmonary acinus with type II hyperplasia of epithelium and
formation of fibrous plugs in the alveolar ducts concordant with
pneumonia inducing bronchiolitis obliterans.
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