Truong Uyen, Moon-Grady Anita J, Butani Lavjay
Department of Pediatrics, Division of Pediatric Cardiology and Section of Pediatric Nephrology, University of California Davis Children's Hospital, Sacramento, CA 95817, USA.
Pediatr Transplant. 2005 Aug;9(4):541-4. doi: 10.1111/j.1399-3046.2005.00323.x.
Because of its lack of nephrotoxicity, the use of sirolimus, as an immunosuppressive agent, has increased considerably in solid-organ transplant (Tx) recipients. With its increased use, Tx professionals are encountering a variety of previously unreported side-effects such as angioedema and interstitial pneumonitis. We describe here the case of a pediatric renal Tx recipient who, while receiving sirolimus, developed a large pericardial effusion requiring pericardiocentesis. An extensive workup for an infectious etiology was performed; the only positive result was isolation of adenovirus type 2 from the patient's stool specimen. Following sirolimus dose reduction this child's effusion stabilized and has not recurred. The purpose of this report is to advise health-care professionals caring for Tx recipients about this potentially life-threatening complication associated with sirolimus. The role of adenovirus, if any, in contributing to the development of our patient's pericardial effusion is discussed herein.
由于西罗莫司缺乏肾毒性，作为一种免疫抑制剂，它在实体器官移植（Tx）受者中的使用已大幅增加。随着其使用的增加，Tx专业人员遇到了各种以前未报告的副作用，如血管性水肿和间质性肺炎。我们在此描述了一名小儿肾移植受者的病例，该受者在接受西罗莫司治疗时出现了大量心包积液，需要进行心包穿刺术。针对感染病因进行了广泛的检查；唯一的阳性结果是从患者的粪便标本中分离出2型腺病毒。在减少西罗莫司剂量后，该患儿的心包积液稳定下来，未再复发。本报告的目的是就这种与西罗莫司相关的潜在危及生命的并发症向照顾Tx受者的医护人员提供建议。本文讨论了腺病毒在导致我们患者心包积液发展过程中（若有）所起的作用。
