Sirolimus-Associated Desquamative Interstitial Pneumonia

Flores-Franco, René Agustín; Luévano-Flores, Eduardo; Gaston-Ramirez, Carlos

doi:10.1159/000097991

Cited by 29 publications

(10 citation statements)

References 4 publications

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“…Arthalgias and aphthous ulcers have also been reported with the use of sirolimus. An uncommon but potentially life-threatening complication of sirolimus is interstitial pneumonia which necessitates immediate cessation and steroids [48]. …”

Section: Rapamycinmentioning

confidence: 99%

A Comprehensive Review of Immunosuppression Used for Liver Transplantation

Mukherjee

Mukherjee²

2009

Journal of Transplantation

120

116

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Since liver transplantation was approved for the treatment of end stage liver disease, calcineurin inhibitors (CNI's) have played a critical role in the preservation of allograft function. Unfortunately, these medications cause a variety of Side effects such as diabetes, hypertension and nephrotoxicity which in turn result in significant morbidity and reduced quality of life. A variety of newer immunosuppressants have been evaluated over the last decade in an attempt to either substitute for CNI's or use with reduced dose CNI's while still preserving allograft function However, current data does not recommend complete cessation of CNI's due to unacceptably high rates of allograft rejection. As these medications have their own unique adverse effects, a careful assessment on their risks and benefits is essential, particularly when additive or synergistic effects with CNI's may occur. Furthermore, the impact of these newer medications on the risk of hepatitis C recurrence and progression remains to be elucidated. Controlled trials are urgently required to assist transplant physicians with choosing the optimum immunosuppressive regimen for their patients. This review will discuss commonly used immunosuppressants prescribed in liver transplantation, emerging therapties and where appropriate, the impact of these medications on the recurrence of hepatitis C after liver transplantation.

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Section: Rapamycinmentioning

confidence: 99%

A Comprehensive Review of Immunosuppression Used for Liver Transplantation

Mukherjee

Mukherjee²

2009

Journal of Transplantation

120

116

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“…In addition, DIP has been associated with connective tissue disease [43,44], rheumatoid arthritis [45], drugs such as sirolimus [46], infection [47][48][49], and users of large amounts of marijuana [50]. All known causes of DIP other than tobacco smoking are summarised in table 2.…”

Section: ¡063610mentioning

confidence: 99%

Desquamative interstitial pneumonia: an analytic review with an emphasis on aetiology

Godbert¹,

Wissler²,

Vignaud³

2013

Eur Respir Rev

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Desquamative interstitial pneumonia (DIP) is characterised by the accumulation of numerous pigmented macrophages within most of the distal airspace of the lung and, sometimes, the presence of giant cells. Diagnosis of DIP is not easy and requires surgical lung biopsy. DIP is usually associated with tobacco smoke. However, the association between smoking and DIP is less robust than that with respiratory bronchiolitis with interstitial lung disease or pulmonary Langerhans' cell histiocytosis; approximately 10-42% of patients with DIP are nonsmokers. DIP can also occur in patients following exposure to certain inhaled toxins (occupational exposure) and drugs, and may occur in the context of certain viral illnesses and autoimmune diseases. In the context of DIP, occupational exposure should be systematically investigated.

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“…Initially, it was believed that its histological feature was the desquamation of epithelial cells, but then it was recognized that the presence of intra-alveolar macrophages was due to an alveolar filling process [23]. This interstitial disorder is associated to tobacco in nearly 80-90% of patients [16,17] but, in contrast to RB-ILD, this illness could also be associated to many drugs [24,25], systemic disorders [26,27], environmental exposures [28], and infections [29]. In addition, it also has been described in children [30].…”

Section: Desquamative Interstitial Pneumoniamentioning

confidence: 99%

Smoking and Other Interstitial Lung Diseases

2011

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Cigarette smoking has been implicated in the development of some uncommon respiratory interstitial diseases. Desquamative interstitial pneumonia and respiratory bronchiolitis-associated interstitial lung diseases are characterized by a diffuse alveolar and peribronchiolar filling with macrophages, respectively. Pulmonary Langerhans' cell histiocytosis is a rare interstitial lung disorder characterized by the proliferation of Langerhans' cell forming interstitial infiltrates and nodules that could progress to cavitary nodules. The treatment of these disorders involves smoking cessation and sometimes the use of steroids. High-resolution computed tomography is essential for the characterization of these smoking-related interstitial lung diseases, but frequently it is necessary to create a workgroup composed by pulmonologists, pathologists, and radiologists to diagnosis and treat patients affected with these pathologies.

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Sirolimus-Associated Desquamative Interstitial Pneumonia

Cited by 29 publications

References 4 publications

A Comprehensive Review of Immunosuppression Used for Liver Transplantation

A Comprehensive Review of Immunosuppression Used for Liver Transplantation

Desquamative interstitial pneumonia: an analytic review with an emphasis on aetiology

Smoking and Other Interstitial Lung Diseases

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