Sirolimus-associated pericardial effusion with cardiac tamponade and interstitial pneumonitis in a hematopoietic stem cell transplant recipient

Pediatr Transplant. 2019 Jun;23(4):e13425. doi: 10.1111/petr.13425. Epub 2019 Apr 23.

Abstract

Sirolimus, a mammalian target of rapamycin (mTOR) inhibitor, is a potent immunosuppressant that is increasingly used in prevention and treatment of graft-vs-host disease (GVHD) in allogeneic hematopoietic stem cell transplant (HSCT) patients. However, data regarding its adverse effects in HSCT patients remain limited. We describe an 18-year-old HSCT patient with a history of invasive fungal infection, who developed pericardial effusion with cardiac tamponade and interstitial pneumonitis while receiving sirolimus for GVHD prophylaxis. Our case illustrates potentially life-threatening complications of sirolimus use in allogeneic HSCT patients.

Keywords: adverse effects; aplastic anemia; cardiopulmonary toxicity; mTOR inhibitor.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Cardiac Tamponade / complications*
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation / adverse effects*
  • Humans
  • Immunosuppressive Agents / adverse effects*
  • Lung Diseases, Interstitial / complications*
  • Male
  • Mycoses / complications
  • Pericardial Effusion / complications*
  • Postoperative Complications / diagnosis*
  • Recurrence
  • Siblings
  • Sirolimus / adverse effects*

Substances

  • Immunosuppressive Agents
  • Sirolimus