Cheng Joyce Y, Cohen Philip R
Department of Internal Medicine, University of California, San Diego.
Department of Dermatology, University of California, San Diego.
Cureus. 2017 Jun 27;9(6):e1398. doi: 10.7759/cureus.1398.
Sirolimus is an immunosuppressant drug used to prevent organ rejection in transplant patients. We describe a man with sirolimus-associated pruritus and review the features of this adverse event in other individuals receiving this drug. The patient was a 67-year-old heart transplant recipient receiving sirolimus as part of his immunosuppressive regimen. He developed severe pruritus over the distal extremities, face, and earlobes six months after starting the drug. The symptoms became progressively worse as he continued to receive this medication. Temporary elimination of the drug resulted in cessation of his itching. Subsequently, sirolimus was discontinued and everolimus was started; this provided temporary relief of his pruritus. PubMed was used to review the following terms: "sirolimus", "itch", and "pruritus." Relevant papers and their references were reviewed. We are aware of only one other patient in whom pruritus necessitated cessation of treatment with sirolimus. Systemic pruritus is a rare adverse event associated with sirolimus. It can occur in both heart and liver transplant patients, beginning several months after transplant, and typically persists. Dose reduction may improve symptoms. Discontinuation of the medication or use of alternative immunosuppressants may be necessary for complete symptom relief.
西罗莫司是一种免疫抑制剂药物，用于预防移植患者的器官排斥反应。我们描述了一名患有西罗莫司相关性瘙痒症的男性，并回顾了其他接受该药物治疗的个体中这一不良事件的特征。该患者是一名67岁的心脏移植受者，接受西罗莫司作为其免疫抑制方案的一部分。在开始使用该药物六个月后，他的远端肢体、面部和耳垂出现了严重瘙痒。随着他继续服用这种药物，症状逐渐加重。暂时停用该药物后他的瘙痒停止。随后，停用了西罗莫司并开始使用依维莫司；这使他的瘙痒得到了暂时缓解。使用PubMed检索了以下术语：“西罗莫司”、“瘙痒”和“瘙痒症”。对相关论文及其参考文献进行了回顾。我们仅知道另外一名患者因瘙痒而不得不停止使用西罗莫司治疗。全身性瘙痒是一种与西罗莫司相关的罕见不良事件。它可发生在心脏和肝脏移植患者中，在移植后数月开始出现，并且通常会持续存在。减少剂量可能会改善症状。为了完全缓解症状，可能需要停用该药物或使用替代免疫抑制剂。
