Vlahakis Nicholas E, Rickman Otis B, Morgenthaler Timothy
Division of Pulmonary and Critical Care Medicine and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA.
Mayo Clin Proc. 2004 Apr;79(4):541-5. doi: 10.4065/79.4.541.
Sirolimus is an immunosuppressive medication used in transplant recipients. To our knowledge, we describe the third reported case of alveolar hemorrhage in association with sirolimus. Fever, dyspnea, hemoptysis, and lung infiltrates resolved rapidly with cessation of sirolimus therapy both initially and after reinstitution of the drug. Unlike previous reports, our patient had no evidence of lymphocytic alveolitis but rather marked macrophage hemosiderosis, suggesting that sirolimus pulmonary toxicity may manifest through 2 separate mechanisms. Our case highlights an uncommon but potentially lethal manifestation of sirolimus pulmonary toxicity.
西罗莫司是一种用于移植受者的免疫抑制药物。据我们所知，我们描述了第三例与西罗莫司相关的肺泡出血病例。发热、呼吸困难、咯血和肺部浸润在最初停用西罗莫司治疗以及重新使用该药物后均迅速缓解。与之前的报告不同，我们的患者没有淋巴细胞性肺泡炎的证据，而是有明显的巨噬细胞含铁血黄素沉着，这表明西罗莫司的肺部毒性可能通过两种不同的机制表现出来。我们的病例突出了西罗莫司肺部毒性一种罕见但可能致命的表现。
