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NDT Advance Access published online on July 25, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn401
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Severe everolimus-associated pneumonitis in a renal transplant recipient

Simona Alexandru1, Alberto Ortiz1, Sonia Baldovi1, Jose Maria Milicua2, Elena Ruíz-Escribano2, Jesús Egido1 and Juan José Plaza1

1 Nephrology Unit 2 Intensive Care Unit, Fundación Jiménez Díaz-Capio, Universidad Autónoma, Madrid, Spain

Correspondence and offprint requests to: Simona Alexandru, Nephrology Unit, Fundación Jiménez Díaz-Capio, Av Reyes Catolicos 2, 28040 Madrid, Spain. Tel: +34-9155-04940; Fax: +34-9155-42636; E-mail: salexandru{at}fjd.es, simona_amely{at}yahoo.com



  Abstract

Inhibitors of mTOR (mammalian target of rapamycin) are immunosuppressants with less nephrotoxic potential than calcineurin inhibitors and antiproliferative effects, which are advantageous in the case of malignancy. However, a series of adverse events has been reported with the first-generation mTOR inhibitor sirolimus that includes hypersensitivity-like interstitial pneumonitis. To our knowledge, only one case of a pneumonitis associated with everolimus in a heart transplant patient has been reported, and it was related to elevated trough blood levels. We report herein the first case of a kidney graft recipient who developed everolimus-associated pneumonitis with normal trough blood levels that was completely reversed after drug withdrawal.

Keywords: everolimus; pneumonitis; sirolimus; transplantation

Received for publication: 17. 3.08
Accepted in revised form: 24. 6.08


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