Interstitial pneumonitis sirolimus

Rapamycin, also known as sirolimus, is a new macrolide antibiotic that interacts with cellcycle regulating proteins and inhibits cell division. The main side effects are thrombocytopenia and hyperlipidaemia. There is also evidence that it causes interstitial pneumonitis, which may resolve on withdrawing the drug or dose reduction. The drug is currently being assessed for combination therapy with tacrolimus or cyclosporin. 

Progressive diffuse interstitial pneumonitis has been reported as a possible adverse effect of sirolimus (4), and by 2000 the FDA was aware of at least 34 cases (5). Although the reports were insufficient to conclude that sirolimus was responsible in most cases, eight patients recovered after sirolimus withdrawal. 

Morelon E, Stern M, Kreis H. Interstitial pneumonitis associated with sirolimus therapy in renal-transplant recipients. N Engl J Med 2000 343(3) 225-6. 

Respiratory More cases of sirolimus-associ-ated interstitial pneumonitis have been reported (see also Everolimus) [56, ... 

Feagans J, Victor D, Moehlen M, Florman SS, Regenstein F, Balart LA, Joshi S, Killackey MT, Slakey DP, Paramesh AS. Interstitial pneumonitis in the transplant patient consider sirolimus-associated pulmonary toxicity. J La State Med Soc 2009 161(3) 166, 168-172. 

In a retrospective study, 12 renal transplant patients (16.7%) on sirolimus developed interstitial pneumonitis. 

Ussavarungsi KEA, Laski M, Raj R, Nugent K. Sirolimus induced granulomatous interstitial pneumonitis. Respir Med Case Rep 2012 7 8-11. 

Garrean S, Massad MG, Tshibaka M, Hanhan Z, Caines AE, Benedetti E (2005) Sirolimus-associated interstitial pneumonitis in solid organ transplant recipients. Clin Transplant 19(5) 698-703... 

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