Sirolimus-associated eyelid edema in kidney transplant recipients

Background. The immunosuppressant sirolimus is effective in preventing acut e rejection episodes. So far, unusual edema formation has not been reported as a side effect. Methods. Two groups of patients with renal transplants, consisting of 11 pa tients each, were followed for up to 29 months. The immunosuppressive regim en was either sirolimus and prednisone with or without cyclosporine or azat hioprine/mycophenolate and prednisone with cyclosporine. Routine follow-up included a thorough clinical investigation. Edema formation was documented photographically. Results. In 5 of the 11 patients treated with sirolimus uni- or bilateral, non-itching, eyelid edema was observed. After discontinuation of sirolimus, lid edema disappeared. The duration until recovery varied from weeks to mo nths. No cause of edema formation other than the treatment with sirolimus w as detected. Conclusions. Severe eyelid edema formation seems to be associated with siro limus treatment. The underlying mechanism is unknown.