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The Drug-Induced Respiratory Disease Website and App

Sirolimus

See also under 'mTOR' inhibitors

Frequency - Incidence

Incidence of respiratory adverse event(s) due to the specific drug as assessed by number of reported/published cases in the literature. Red digits in stars indicate: 0 = Very rare, questionable signal · 1 = < 10 cases · 2 = 10-50 cases · 3 = 50–100 cases · 4 = 100-200 cases · 5 = >200 cases

Evidence level/grade

Evidence level for respiratory adverse event(s) due to the specific drug as estimated using Hill’s (1965), Naranjo’s (1981), and Bégaud’s (1985) criteria applied to published cases. Blue digits in stars indicate: 0 = Questionable · 1 = Low · 2 = Moderate · 3 = Robust · 4 = Definite · 5 = Unquestionable, pathognomonic

I - Interstitial/parenchymal lung disease

I.a

Pneumonitis (ILD), acute and/or severe (may produce the ARDS pattern)
I.b

Pneumonitis (interstitial lung disease/ILD)
I.d

Organizing pneumonia pattern (an area or areas of consolidation on imaging)
I.f

Acute fibrinous organizing pneumonia (AFOP)
I.l

Diffuse alveolar damage (DAD) (see alsoo under IIb and XVf)
I.m

ILD with a granulomatous component
I.n

Pulmonary alveolar proteinosis (PAP) (secondary)

II - Pulmonary edema - Acute lung injury - ARDS

II.b

ARDS - Acute lung injury

III - Pulmonary/alveolar/airway hemorrhage/bleeding

III.a

Alveolar hemorrhage (AH), diffuse AH (DAH)

IV - Airway involvement

IV.d

Cough (lone)
IV.l

Bronchial stump dehiscence
IV.o

Airway hyperresponsiveness

V - Pleural and/or pericardial involvement

V.m

Pleuropericarditis - Pleuropericardial effusion (ANA unknown or negative)

VI - Pulmonary vasculopathy

VI.a

Pulmonary embolism - Venous thrombosis/thromboembolism
VI.d

Pulmonary vasculitis or capillaritis
VI.f

Hemolytic and uremic syndrome (HUS). See also under Xaf

VIII - Central-large-upper airway (incl. pharyngeal-nasal) involvement

VIII.a

Angioedema (may cause UAO, asphyxia and death)

X - Systemic/Distant conditions, syndromes and reactions

X.c

Capillary leak syndrome (CLS)

XII - Cardiovascular involvement / toxicity

XII.c

Pericardial effusion (w/wo tamponade)

XV - Pathology

XV.c

Path: Organizing pneumonia (OP/BOOP) pattern (see also Id)
XV.d

Path: Acute fibrinous organizing pneumonia (AFOP-pattern) (see also pattern If)
XV.e

Path: ILD with a granulomatous component (see also Im)
XV.f

Path: Diffuse alveolar damage (DAD-pattern) (see also IL)
XV.g

Path: Alveolar hemorrhage (see also IIIa)
XV.k

Path: Desquamative interstitial pneumonia (DIP-pattern)
XV.m

Path: Lymphoid hyperplasia (including nodular- or a lymphocytic interstitial pneumonia pattern)
XV.n

Path: Pulmonary alveolar proteinosis pattern (PAP pattern)
XV.ac

Path: Pulmonary vasculitis other than capillaritis
XV.bf

Path: Pulmonary necrotizing granuloma or granulomas

XVI - Imaging

XVI.b

Imaging: Ground-glass opacities (GGO) / shadowing
XVI.k

Imaging: An area or areas of consolidation

XVII - Infections & related conditions

XVII.b

Opportunistic pulmonary/systemic infections
XVII.e

Pneumocystis jiroveci pneumonia

XIX - Cytological, biochemical features of/in BAL, pleural fluid or FNA

XIX.a

BAL: An excess proportion of lymphocytes