Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms

Detalhes bibliográficos
Autor(a) principal: Rocha,Sofia
Data de Publicação: 2012
Outros Autores: Pedroso,Sofia, Almeida,Manuela, Dias,Leonídio, Martins,La Salete, Henriques,António C., Cabrita,António
Tipo de documento: Relatório
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000200005
Resumo: Sirolimus, a mammalian target of rapamycin inhibitor, is an increasingly used immunosuppressant in solid-organ transplantation. There are an increasing number of reports of unusual oedematous adverse effects associated with this drug, including lymphoedema, ascites and pleural effusions, and a few reports of pericardial effusions. No pathophysiological explanation for these phenomena has been disclosed. We report a 33-year-old sirolimus-treated kidney transplant recipient with chronic pericardial and pleural effusions identified nine years after transplantation. He was initially treated for a presumed tuberculous pericarditis, even though cultures for Mycobacterium tuberculosis were negative. After 12 months of antitubercular therapy, visceral effusions persisted. Pericardial effusion was drained and stabilised. After exclusion of other causes, sirolimus toxicity was considered the most likely cause. Two months after discontinuation of sirolimus, visceral effusions disappeared. Interaction of mammalian target of rapamycin inhibitors with mediators of lymphangiogenesis may be a common link in oedematous states associated with sirolimus.
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spelling Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanismsImmunosuppressionkidney transplantationlymphangiogenesismTOR inhibitorsrapamycinserositisSirolimus, a mammalian target of rapamycin inhibitor, is an increasingly used immunosuppressant in solid-organ transplantation. There are an increasing number of reports of unusual oedematous adverse effects associated with this drug, including lymphoedema, ascites and pleural effusions, and a few reports of pericardial effusions. No pathophysiological explanation for these phenomena has been disclosed. We report a 33-year-old sirolimus-treated kidney transplant recipient with chronic pericardial and pleural effusions identified nine years after transplantation. He was initially treated for a presumed tuberculous pericarditis, even though cultures for Mycobacterium tuberculosis were negative. After 12 months of antitubercular therapy, visceral effusions persisted. Pericardial effusion was drained and stabilised. After exclusion of other causes, sirolimus toxicity was considered the most likely cause. Two months after discontinuation of sirolimus, visceral effusions disappeared. Interaction of mammalian target of rapamycin inhibitors with mediators of lymphangiogenesis may be a common link in oedematous states associated with sirolimus.Sociedade Portuguesa de Nefrologia2012-04-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000200005Portuguese Journal of Nephrology & Hypertension v.26 n.2 2012reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000200005Rocha,SofiaPedroso,SofiaAlmeida,ManuelaDias,LeonídioMartins,La SaleteHenriques,António C.Cabrita,Antónioinfo:eu-repo/semantics/openAccess2024-02-06T17:04:39Zoai:scielo:S0872-01692012000200005Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:18:48.972669Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms
title Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms
spellingShingle Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms
Rocha,Sofia
Immunosuppression
kidney transplantation
lymphangiogenesis
mTOR inhibitors
rapamycin
serositis
title_short Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms
title_full Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms
title_fullStr Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms
title_full_unstemmed Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms
title_sort Pericardial and pleural effusions associated with sirolimus and discussion of possible mechanisms
author Rocha,Sofia
author_facet Rocha,Sofia
Pedroso,Sofia
Almeida,Manuela
Dias,Leonídio
Martins,La Salete
Henriques,António C.
Cabrita,António
author_role author
author2 Pedroso,Sofia
Almeida,Manuela
Dias,Leonídio
Martins,La Salete
Henriques,António C.
Cabrita,António
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Rocha,Sofia
Pedroso,Sofia
Almeida,Manuela
Dias,Leonídio
Martins,La Salete
Henriques,António C.
Cabrita,António
dc.subject.por.fl_str_mv Immunosuppression
kidney transplantation
lymphangiogenesis
mTOR inhibitors
rapamycin
serositis
topic Immunosuppression
kidney transplantation
lymphangiogenesis
mTOR inhibitors
rapamycin
serositis
description Sirolimus, a mammalian target of rapamycin inhibitor, is an increasingly used immunosuppressant in solid-organ transplantation. There are an increasing number of reports of unusual oedematous adverse effects associated with this drug, including lymphoedema, ascites and pleural effusions, and a few reports of pericardial effusions. No pathophysiological explanation for these phenomena has been disclosed. We report a 33-year-old sirolimus-treated kidney transplant recipient with chronic pericardial and pleural effusions identified nine years after transplantation. He was initially treated for a presumed tuberculous pericarditis, even though cultures for Mycobacterium tuberculosis were negative. After 12 months of antitubercular therapy, visceral effusions persisted. Pericardial effusion was drained and stabilised. After exclusion of other causes, sirolimus toxicity was considered the most likely cause. Two months after discontinuation of sirolimus, visceral effusions disappeared. Interaction of mammalian target of rapamycin inhibitors with mediators of lymphangiogenesis may be a common link in oedematous states associated with sirolimus.
publishDate 2012
dc.date.none.fl_str_mv 2012-04-01
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/report
format report
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000200005
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692012000200005
dc.language.iso.fl_str_mv eng
language eng
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dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.source.none.fl_str_mv Portuguese Journal of Nephrology & Hypertension v.26 n.2 2012
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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