Pulmonary alveolar proteinosis ? a rare pulmonary toxicity of sirolimus
| Autor: | António Castro Henriques, António Cabrita, A.M. Sarmento, Sofia Pedroso, La Salete Martins, Leonídio Dias, Abílio Reis, Sónia Sousa |
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| Rok vydání: | 2007 |
| Předmět: |
Adult
medicine.medical_specialty Pulmonary toxicity medicine.medical_treatment Pulmonary Alveolar Proteinosis Chest pain Gastroenterology Chronic allograft nephropathy Internal medicine medicine Humans Sirolimus Transplantation medicine.diagnostic_test business.industry Immunosuppression medicine.disease Kidney Transplantation Surgery Bronchoalveolar lavage Female medicine.symptom Tomography X-Ray Computed Pulmonary alveolar proteinosis business Complication Immunosuppressive Agents |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP |
| ISSN: | 1432-2277 0934-0874 |
| DOI: | 10.1111/j.1432-2277.2006.00408.x |
| Popis: | Transpl Int. 2007 Mar;20(3):291-6. Pulmonary alveolar proteinosis: a rare pulmonary toxicity of sirolimus. Pedroso SL, Martins LS, Sousa S, Reis A, Dias L, Henriques AC, Sarmento AM, Cabrita A. Nephrology Department, Hospital Geral de Santo António, Porto, Portugal. sofiapedroso@sapo.pt Abstract The aim of our paper is to describe an unusual pulmonary toxicity of sirolimus (SRL) in a kidney transplant recipient. We present a 34-year-old woman with a second renal transplantation, complicated with steroid-resistant acute rejection and chronic allograft dysfunction. Two years after initiating SRL, she presented complaints of progressive dyspnoea, nonproductive cough, chest pain and low-grade fever of 1 month duration. She had chronic allograft nephropathy and slight elevation of lactic dehydrogenase levels. After exclusion of common reasons of this condition, a computed tomography (CT) of the thorax and bronchoscopy was performed, revealing ground-glass opacification with polygonal shapes on CT and an opaque appearance with numerous macrophages on bronchoalveolar lavage. The alveolar macrophages stained positive by Periodic acid-Schiff. Diagnosis of pulmonary alveolar proteinosis (PAP) was made and drug-induced toxicity was suspected. SRL was withdrawn with marked improvement in the patients' clinical and radiological status. PAP resolved within 3 months without further therapy. PAP is a very rare complication of SRL therapy with only a few cases described. Withdrawal of SRL with conversion to another immunosuppressant seems to be an appropriate procedure in this condition. PMID: 17291222 [PubMed - indexed for MEDLINE |
| Databáze: | OpenAIRE |
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