Presentation
A term newborn presented with widespread cutaneous erythematous to bluish lesions since birth. He had extensive lesions in the gastrointestinal tract, brain, retina, heart, and bones. [ncbi.nlm.nih.gov]
Entire Body System
- Hunting
Crossref Medline Google Scholar 17 Hunt J, Bedanova H, Starling RC, Rabago G, Banner NR, Kobashigaqa J, Keogh A, Kormos R, Mehra M, Wahlers T, Noeldeke J. [circ.ahajournals.org]
O’Connell BM, Abel EA, Nickoloff BJ, Bell BJ, Hunt SA, Theodore J, et al: Dermatologic complications following heart transplantation. [karger.com]
Related Books & Audiobooks Free with a 30 day trial from Scribd The Secret to Superhuman Strength Alison Bechdel (5/5) Free Hunt, Gather, Parent: What Ancient Cultures Can Teach Us About the Lost Art of Raising Happy, Helpful Little Humans Michaeleen [slideshare.net]
- Congestive Heart Failure
Common side effects include atrial fibrillation, congestive heart failure, hypotension, palpitations, tachycardia, tremors, headache, paresthesia, dyspnea, rash, and acne. sirolimus A macrolide immunosuppressant that is structurally similar to tacrolimus [medical-dictionary.thefreedictionary.com]
These include conditions causing significant central nervous system (CNS) or autonomic dysfunction, including congestive heart failure, recent ( 10g%), alcoholism, amyloidosis, uncontrolled hypothyroidism, sympathectomy, unstable peripheral neuropathies [clinicaltrials.gov]
Also, adverse effects from sirolimus may include atrial fibrillation, congestive heart failure, hypervolemia, and palpitations. [pdr.net]
Respiratoric
- Cough
While on sirolimus our patient developed cough, fever, and patchy infiltrates, which failed to respond to multiple courses of antibiotic therapy. [ncbi.nlm.nih.gov]
Analysis of available data for 15 patients revealed that the most commonly presenting symptoms were dyspnea on exertion and dry cough followed by fatigue and fever. [doi.org]
- Pleural Effusion
CLINICAL RELEVANCE: we present the first clinical cases of EGS with pleural effusion with response to sirolimus treatment that could be an alternative to the current therapy. [ncbi.nlm.nih.gov]
A moderate-large pericardial effusion and bilateral pleural effusions were disclosed. Due to the size of the pericardial effusion and the absence of cardiac tamponade, we presumed that the effusion was slowly progressive. [scielo.mec.pt]
effusion, atelectasis, and lymphoma. [medical-dictionary.thefreedictionary.com]
- Respiratory Insufficiency
One woman had a respiratory insufficiency and received the oxygen therapy. Loss of weight (more than 10% in the last three months) was observed in 7 patients. [omicsonline.org]
insufficiency (continuous oxygenotherapy) - Daily hemoptysis - Infections (1x/month) - Altered growth - Poor quality of life 41 months, ongoing - Functional improvement (decreased oxygen-dependency) - Reduction of hemoptysis - Reduction of infection [ojrd.biomedcentral.com]
Jaw & Teeth
- Oral Ulcers
The side-effects were tolerable and included oral ulcer, fever, pain, skin rash and transient ascension of serum transaminase and cholesterol. [ncbi.nlm.nih.gov]
The only side effects presented were oral ulcers and brittle nails. [archbronconeumol.org]
28 months Therapy slowed the decline of lung function with side effects including oral ulcers and brittle nails 31 y/o female with end-stage LAM 18 5 months after a double lung transplant, patient received sirolimus 1 mg/day for treatment of re-accumulated [specialtypharmacytimes.com]
Common side effects of sirolimus include dyslipidaemia, proteinuria, anaemia, thrombocytopenia, decreased wound healing, oral ulcers and lymphoceles. [scielo.mec.pt]
Cardiovascular
- Tachycardia
Reversion of the atrial ectopic tachycardia was achieved with mammalian target of rapamycin pathway (mTOR) inhibitor sirolimus. As per our knowledge, this is the first time that sirolimus has been successfully used in this setting. [ncbi.nlm.nih.gov]
Adverse reactions CNS: headache, drowsiness, paresthesia, hypoesthesia, hypertonia, hypertonia, emotional lability, dizziness, confusion, syncope, malaise, asthenia, depression, anxiety, tremor, insomnia CV: hypertension, hypotension, tachycardia, chest [medical-dictionary.thefreedictionary.com]
Serious adverse events seen in the treatment group were pericarditis, atrial arrhythmia, tachycardia, and fluid overload after embolization of an angiomyolipoma. [specialtypharmacytimes.com]
Cardiovascular Very common (10% or more): Peripheral edema (up to 58%), hypertension (up to 49%), chest pain (up to 24%), edema (up to 18%), lymphocele Common (1% to 10%): Venous thromboembolism (including pulmonary embolism, deep venous thrombosis ), tachycardia [drugs.com]
Cardiovascular – Venous thromboembolism (including pulmonary embolism, deep venous thrombosis), tachycardia. Digestive System – Stomatitis. [dailymed.nlm.nih.gov]
Skin
- Ulcer
2003 to May 2010, then replaced by Everolimus: severe mouth ulcers started immediately and never left me till 11/2009, from then on I have never suffered of them anymore. [transplantbuddies.org]
Patients must have vascular anomalies that have the potential to cause significant morbidity: coagulopathy, chronic pain, recurrent cellulitis, ulceration, visceral or bone involvment, cardiac dysfunction. [novanews.org]
The side-effects were tolerable and included oral ulcer, fever, pain, skin rash and transient ascension of serum transaminase and cholesterol. [ncbi.nlm.nih.gov]
UC: Ulcerative colitis, CD: Crohn's disease. [academic.oup.com]
- Skin Disease
On DermNet NZ Skin cancers in transplant patients Other websites Sirolimus. Medscape Reference Books about skin diseases See the DermNet NZ bookstore. [dermnetnz.org]
Diseases (MAGEC), University Paris Descartes-Sorbonne Paris Cité, Institute Imagine, University Hospital Necker-Enfants Malades, Paris, France; [email protected] [email protected] 3 Department of Pathology, University Hospital [ncbi.nlm.nih.gov]
Exviera dasabuvir sodium, Hepatitis C, Chronic Date of authorisation: 14/01/2015,, Revision: 15, Authorised, Last updated: 23/01/2019 List item Human medicine European public assessment report (EPAR): Sivextro tedizolid phosphate, Soft Tissue Infections, Skin [ema.europa.eu]
Goldspiel PharmD & Parag Kumar PharmD Department of Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université Paris Descartes - Sorbonne Paris Cité, INSERM U1163, Institut Imagine, Institut Imagine, Hôpital Universitaire [nature.com]
- Acne Vulgaris
[…] nausea / Early / 20.0 diarrhea / Early / 20.0 myalgia / Early / 20.0 headache / Early / 20.0 dizziness / Early / 20.0 alopecia / Delayed / 10.0 xerosis / Delayed / 10.0 pruritus / Rapid / 10.0 onycholysis / Delayed / 10.0 folliculitis / Delayed / 10.0 acne [pdr.net]
- Acneiform Eruption
We report 2 cases of follicular acneiform eruptions induced by sirolimus in renal allograft recipients. This dermatologic complication was severe and difficult to treat, and resolved only after discontinuation of sirolimus. © 2005 S. [karger.com]
Psychiatrical
- Suggestibility
Our structure explains how FKBP-rapamycin and architectural elements of mTORC1 limit access to the recessed active site, and suggests a mechanism for the role of Raptor in substrate recognition and delivery: the conserved amino-terminal CASPase-like domain [bangroup.ethz.ch]
[…] other mTOR inhibitors The risk of cancer is increased after kidney transplantation and is predominantly attributed to oncogenic immunosuppression. 1 It is a leading cause of death for kidney allograft recipients, and analyses of transplant registry data suggest [bmj.com]
However, the proteinuria resolved after discontinuation of sirolimus, which suggests a direct effect of the drug. [cjasn.asnjournals.org]
The second pregnancy on uninterrupted low-dose sirolimus (plasma levels 3-5 mg/L) was uncomplicated both with respect to mother and child suggesting that low-dose sirolimus might be safe in selected pregnant patients with stable LAM. [ncbi.nlm.nih.gov]
Neurologic
- Excitement
This is an exciting area for development and poses many challenges to researchers. [ncbi.nlm.nih.gov]
“[This study is] exciting because it shows that it’s feasible to do this in a mammal,” says David Sinclair, codirector of the Paul F. [technologyreview.com]
While it is exciting to finally have a pharmacotherapy option for patients with LAM, the pros and cons for each individual patient should be considered before initiating therapy. [specialtypharmacytimes.com]
Workup
A workup of infectious causes was undertaken and was negative. All the patients had resolution of visceral effusions after sirolimus discontinuation. [scielo.mec.pt]
An extensive workup was negative for an infectious etiology, including JC polyomavirus or demyelination. Sirolimus was discontinued and the headaches resolved within a few days. [bloodjournal.org]
Microbiology
- Candida
Rapamycin is mainly active against Candida albicans ; minimum inhibitory concentration against ten strains ranged from 0.02 to 0.2 μg/ml. [doi.org]
A streptomycete was isolated from an Easter Island soil sample and found to inhibit Candida albicans, Microsporum gypseum and Trichophyton granulosum. [ncbi.nlm.nih.gov]
Pleura
- Pleural Effusion
CLINICAL RELEVANCE: we present the first clinical cases of EGS with pleural effusion with response to sirolimus treatment that could be an alternative to the current therapy. [ncbi.nlm.nih.gov]
A moderate-large pericardial effusion and bilateral pleural effusions were disclosed. Due to the size of the pericardial effusion and the absence of cardiac tamponade, we presumed that the effusion was slowly progressive. [scielo.mec.pt]
effusion, atelectasis, and lymphoma. [medical-dictionary.thefreedictionary.com]
Treatment
There is not sufficient evidence to support the routine use of any treatment in LAM. The only treatment for severe LAM is currently lung transplantation. Activation of mammalian target of rapamycin (mTOR) signalling pathway has been observed in LAM. [archbronconeumol.org]
Despite the severity of potential complications, we lack uniform guidelines for the treatment and response to treatment of children and young adults with these diseases. [novanews.org]
BACKGROUND: Systemic treatment with sirolimus, as used for immunosuppression in transplant patients, results in markedly low rates of in-stent restenosis. [ncbi.nlm.nih.gov]
Effect of treatment discontinuation. Summary of observations in 6 patients who discontinued rapamycin treatment. (A) Status of rapamycin treatment is indicated by [−]/[+]. [doi.org]
Prognosis
Its development worsens patient prognosis, with a significant decrease in survival. Currently, there are no unified guidelines regarding its management, and different combinations of immunosuppressants have been used with variable success. [ncbi.nlm.nih.gov]
In this report, we will characterize the temsirolimus-related pneumonitis and not the interferon-related pneumonitis that occurred in patients with poor-prognosis ARCC. [doi.org]
The rapamycin- regulated gene expression signature determines prognosis for breast cancer Molecular Cancer 8(75), (2009). 3. Zhang, H.H., Huang, J., Düvel, K., et al. [caymanchem.com]
Etiology
BACKGROUND: Gorham-Stout disease (GSD) is a rare disease of unknown etiology characterized by vascular proliferation that produces destruction of bone matrix. [ncbi.nlm.nih.gov]
Currently, we leverage a variety of techniques to study the etiology and pathogenesis of iMCD. [med.upenn.edu]
Based on the absence of a previous infectious condition and any signs of rejection in the endocardial biopsy that could be triggers, and given the recent introduction of sirolimus, the latter was considered the etiological factor, with blood levels within [revespcardiol.org]
Epidemiology
Epidemiologic literature is saturated with general discussions of the limitations of retrospective studies. Posttransplantation diabetes is a relatively frequent and unfortunate complication in patients carrying renal allografts. [jasn.asnjournals.org]
Clinical features, epidemiology, and therapy of lymphangioleiomyomatosis. Clin Epidemiol. 2015;7:249-57. Lee L, Sudentas P, Donohue B, et al. Efficacy of a Rapamycin Analog (CCI-779) and INF-gamma in Tuberous Sclerosis Mouse Models. [specialtypharmacytimes.com]
An epidemiological study of renal pathology in tuberous sclerosis complex. BJU Int. 2004;94:853–7. 25. Marti HP, Frey FJ. Nephrotoxicity of rapamycin: an emerging problem in clinical medicine. Nephrol Dial Transplant. 2005;20:13–5. 26. [ojrd.biomedcentral.com]
Aarhus University Hospital, Aarhus, Denmark (5) Department of Epidemiology, Boston University, Boston, MA, USA References Moses JW, Leon MB, Popma JJ, Fitzgerald PJ, Holmes DR, O’Shaughnessy C, et al: Sirolimus-eluting stents versus standard stents [bmccardiovascdisord.biomedcentral.com]
CLINICAL EPIDEMIOLOGY JASN July 2008, 19 (7) 1411-1418; DOI: https://doi.org/10.1681/ASN.2007111202 This article requires a subscription to view the full text. If you have a subscription you may use the login form below to view the article. [doi.org]
Pathophysiology
This case highlights the need for early recognition of adverse drug effects and further research into their pathophysiology and management. [ncbi.nlm.nih.gov]
[…] concentration during therapy, particularly in individuals coadministered CYP3A4 substrates, inhibitors, or inducers Adjusting dose to optimize immunosuppression while minimizing toxicity Evaluating patient compliance Clinical Information Discusses physiology, pathophysiology [mayomedicallaboratories.com]
Oxygen and BagValveMask Ventilation 217 Assessment and Management of the Pediatric Airway 223 Vascular Access 253 Shock An Overview 274 Acute Respiratory Failure 299 Pediatric Transport Medicine 308 Withdrawal of Life Support 320 Brain Death 324 The Pathophysiology [books.google.ro]
The exact pathophysiology is unknown. [revespcardiol.org]
Prevention
antibacterial drug A drug used to treat or prevent bacterial infections. antifungal drug Any antifungal agent used to prevent or treat fungal infections in humans or animals. [ebi.ac.uk]
Also called rapamycin. sirolimus an immunosuppressant. indications It is used after organ transplantation to prevent rejection. [medical-dictionary.thefreedictionary.com]
CONCLUSION: Our findings show that systemic sirolimus treatment effectively prevents SMC and EC proliferation in vivo without directly affecting these cells. [ncbi.nlm.nih.gov]
It is a potent immunosuppressant having a variety of uses both in vitro and in vivo and is used to prevent organ rejection after transplantation. [agscientific.com]