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RENAL TRANSPLANTASYON SONRASI SİROLİMUS İLE İLİŞKİLİ İNTERSTİSYEL PNÖMONİ: BİR AŞIRI DUYARLILIK CEVABI MI?

SIROLIMUS ASSOCIATED INTERSTITIAL PNEUMONITIS IN A RENAL TRANSPLANT PATIENT: IS ITAHYPERSENSITIVITY RESPONSE?

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 2007

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
Sirolimus is a maintenance immunosuppressive agent after renal transplantation. Interstitial pneumonitis due to sirolimus which had no identified infectious etiology has been recently reported. We describe a case of recurrent sirolimus associated interstitial pneumonitis after renal transplantation, on the basis of its mechanism of action. The diagnosis of sirolimus-associated pulmonary toxicity was made after an exhaustive work-up to exclude infectious causes and other pulmonary disease. Sirolimus discontinuation resulted in clinical and radiologic improvement of interstital pneumonitis within 2 weeks. The precise etiology underlying sirolimus-induced pneumonitis remains unknown. However, observations in animals and humans indicate that this agent may cause lung injury in selected cases via differential regulation of the Th1/Th2 lymphocyte balance. We thought that bronchoalveolar lavage cell counts may provide some information about the mechanism of sirolimus-induced pneumonitis.
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Abstract (Original Language): 
Sirolimus renal transplantasyon sonras›nda idame tedavide kullan›lmakta olan bir immunsupresif ajand›r. Herhangi bir infeksiyöz etyolojinin saptanmad›¤› sirolimusa ba¤l› interstisyel pnömoni yak›n zamanda bildirilmifltir. Renal transplantasyon sonras› sirolimus ile iliflkili rekürren interstisyel pnömoni geçiren bir olguyu, etki mekanizmas›n› temel alarak tan›mlad›k. Bu vakada, sirolimus ile iliflkili interstisyel pulmoner toksisite tan›s›, infeksiyöz nedenleri ve di¤er pulmoner hastal›klar› d›fllamak için yap›lan ayr›nt›l› de¤erlendirme sonras›nda konulmufltur. Sirolimus tedavisinin kesilmesi iki hafta içerisinde interstisyel pnömonide klinik ve radyolojik düzelme ile sonuçlanm›flt›r. Sirolimus ile iliflkili olarak ortaya ç›kan interstisyel pnömoninin kesin etyolojisi bilinmemektedir. Bununla birlikte, hayvan ve insanlarda yap›lan araflt›rmalar bu ajan›n seçilmifl vakalarda Th1/Th2 lenfosit oran›nda de¤ifliklikler meydana getirelerek akci¤er hasar›na neden olabilece¤ini göstermektedir. Bronkoalveolar lavaj hücre say›mlar›n›n, sirolimus ile iliflkili interstisyel pnömoninin mekanizmas› ile ilgili bilgi sa¤layabilece¤ine düflünmekteyiz.
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  • 1
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  • English

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