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Review
. 2024 Jan 1;46(1):e91-e93.
doi: 10.1097/MPH.0000000000002793. Epub 2023 Nov 30.

Sirolimus-induced Hypertriglyceridemia Leads to Acute Pancreatitis and Diabetic Ketoacidosis Post Stem Cell Transplant for Sickle Cell Disease

Subhasish Paul  1 , Garima Nirmal  1 , Vaibhav Chadha  1 , Rahul Sharma  1 , Ips Kochar  2 , Namith Jerath  3 , Rohit Vohra  3 , Gaurav Kharya  1
Affiliations
Review

Sirolimus-induced Hypertriglyceridemia Leads to Acute Pancreatitis and Diabetic Ketoacidosis Post Stem Cell Transplant for Sickle Cell Disease

Subhasish Paul et al. J Pediatr Hematol Oncol. .

Abstract

Sirolimus (mammalian target of rapamycin inhibitor) is a potent immunosuppressive agent, used in patients receiving hematopoietic stem cell transplant (HSCT) for Graft vs Host disease prophylaxis. Compared to calcineurin inhibitors, sirolimus has no neurotoxicity or nephrotoxicity, but sirolimus causes dose-dependent thrombocytopenia, leukopenia, delayed wound healing, hyperlipidemia, and hypertriglyceridemia. Here we report a case of acute pancreatitis and diabetic ketoacidosis in a patient with sickle cell disease post haploidentical family donor HSCT which was managed conservatively without plasmapheresis. Based on our review of the literature, this is the first reported case of developing acute pancreatitis as an adverse effect of sirolimus-induced hypertriglyceridemia leading to diabetic ketoacidosis in a recipient of HSCT.

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Conflict of interest statement

The authors declare no conflict of interest.

References

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