Switch to Everolimus for Sirolimus-Induced Pneumonitis in a Liver Transplant Recipient—Not All Proliferation Signal Inhibitors Are the Same: A Case Report

Everolimus and sirolimus in transplantation-related but different

“…Said case reports included sirolimus-induced proteinuria in a liver transplant recipient that improved after switch to everolimus [100] and disappearance of aphthous ulcers under sirolimus [101]. In single kidney [102] and liver [103] transplant patients, sirolimus-induced pneumonitis resolved after switch to everolimus. Nevertheless, an indirect retrospective comparison of kidney transplant patients taking either sirolimus or everolimus at a single center suggested that sirolimus did not cause more cases of pneumonitis than everolimus [104].…”

Calcineurin inhibitor-free GVHD prophylaxis with sirolimus, mycophenolate mofetil and ATG in Allo-SCT for leukemia patients with high relapse risk: an observational cohort study

“…After terminating sirolimus earlier than planned already at day þ 48, the patient's condition improved. In another patient, sirolimus was replaced by everolimus because of suspected pneumonitis, 35 which, however, turned out to be Pneumocystis jirovecii pneumonia after bronchoalveolar lavage was performed and it responded well to high-dose trimethoprim/sulfamethoxazole treatment. All other patients remained on sirolimus until the planed termination of immunosuppression or until relapse.…”

Poumon et immunosuppresseurs : problèmes pratiques

“…Ainsi, la pneumotoxicité des antagonistes de mTOR est bien connue. En cas d'antécédent de pneumopathie avec une de ces molé-cule (SRL ou EVR), si l'apport de cette classe est jugé majeur (transplantation), il peut être raisonnable après guérison d'utiliser l'autre molécule, les réactions croisées SRL/EVR étant inconstantes [7,8]. Un raisonnement analogue peut être tenu avec les rares pneumopathies infiltrantes induites par les anti-TNF.…”