A case of low-dose everolimus (Certican®)-induced pneumonitis
Noriko Takedaa Kazuhisa Asaia Naoki Ijiria Hiroshi Kanazawaa Junji Uchidab Kazuto Hirataa
aDepartment of Respiratory Medicine, Graduate School of Medicine, Osaka City University
bDepartment of Urology, Graduate School of Medicine, Osaka City University
A 70-year-old Japanese man underwent living-donor renal transplantation, with his wife being the donor, in June 2011 for end-stage renal dysfunction. He started receiving low-dose everolimus for immunosuppression from September 2012. Three months later he gradually developed dyspnea (mMRC [modified Medical Research Council] Breathlessness Scale grade 2). His chest computed tomography (CT) scan showed ground-glass opacity. At first, opportunistic infections were suspected and empirical therapies were started. However, the bronchoalveolar lavage fluid (BALF) demonstrated negative results for infection. The percentage of lymphocytes in BALF had significantly increased (54%), and a transbronchial lung biospy (TBLB) specimen showed organizing pneumonia. Drug-induced pneumonitis was suspected, and low-dose everolimus was stopped. After which the patient's symptoms and CT findings improved. We eventually diagnosed a case of low-dose everolimus-induced pneumonitis. Although everolimus-induced pneumonitis is frequently observed in cases of advanced renal cell carcinoma, low-dose everolimus-induced pneumonitis is rare and has never been reported in Japan. To the best of our knowledge, this is the first case of low-dose everolimus-induced pneumonitis in this country.
Drug-induced pneumonitis Everolimus (Certican®) Renal transplantation Immunosuppressant
Received 22 Apr 2013 / Accepted 11 Oct 2013
AJRS, 3(2): 227-231, 2014