Sirolimus‐associated lymphoedema: eight new cases and a proposed mechanism

Summary Sirolimus, an inhibitor of the mammalian target of rapamycin (mTOR), is increasingly used as an agent for post‐transplant immunosuppression and the treatment of solid organ and haematological malignancies and hamartomas. Its advantages include a lack of nephrotoxicity and a lower incidence o...

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Bibliographic Details
Published in:British journal of dermatology (1951) 2009-06, Vol.160 (6), p.1322-1326
Main Authors: Desai, N., Heenan, S., Mortimer, P.S.
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Dermatology
Diseases of the lymphatic vessels
Female
Humans
Immunosuppression
Immunosuppressive Agents - adverse effects
Lymphedema - chemically induced
Lymphedema - diagnostic imaging
lymphoedema
Male
mammalian target of rapamycin inhibitor
Medical sciences
Middle Aged
Radiography
rapamycin
sirolimus
Sirolimus - adverse effects
vascular endothelial growth factor C
vascular endothelial growth factor receptor 3
Young Adult
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Summary:Summary Sirolimus, an inhibitor of the mammalian target of rapamycin (mTOR), is increasingly used as an agent for post‐transplant immunosuppression and the treatment of solid organ and haematological malignancies and hamartomas. Its advantages include a lack of nephrotoxicity and a lower incidence of nonmelanoma skin cancers; adverse effects include delayed wound healing, increased lymphocoele formation and rarely lymphoedema. We report a series of eight cases of severe, sustained, unilateral and bilateral lymphoedema in patients receiving sirolimus for post‐transplant immunosuppression, classify their lymphoscintigraphy findings and propose a mechanism of aetiology based on the interaction of mTOR with key mediators of lymphangiogenesis.
ISSN:0007-0963
1365-2133
DOI:10.1111/j.1365-2133.2009.09098.x