Sirolimus-Induced Interstitial Pneumonitis in an Islet Transplant Recipient

  1. Benigno J. Digon III, MD,
  2. Kristina I. Rother, MD,
  3. Boaz Hirshberg, MD and
  4. David M. Harlan, MD
  1. From the Transplantation and Autoimmunity Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland
  1. Address correspondence to David M. Harlan, MD, Captain, U.S. Public Health Service Chief, NIDDK Transplantation and Autoimmunity Branch, National Institutes of Health, DHHS Building 10, Room 8N307, Bethesda, MD 20892. E-mail:

Islet transplantation can now result in markedly improved metabolic control for a subset of individuals with “brittle” type 1 diabetes. Yet, the immunosuppression required to prevent allograft rejection may come at a high price. We report the first case of an islet transplant recipient with sirolimus-induced interstitial pneumonitis.

A 59-year-old woman with type 1 diabetes since age 7 years became insulin independent after two islet infusions. She developed a gradually worsening, nonproductive cough 68 weeks after transplantation. At that time, her medication consisted of sirolimus, tacrolimus, filgrastim, aspirin, pravastatin, magnesium, …

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