Table 4.
Complications Detected While on Sirolimus Treatment
| Side Effects |
|
|---|---|
| Side effects to sirolimus | 19 (86.4%): Yes |
| 3 (13.6%): No | |
| Time between onset of sirolimus and side effects, median (range), mo | 13 (1–52) |
| Dose sirolimus when side effect detected, median (range), mg/m2/d | 3.1 (0.5–17.4) |
| Levels of sirolimus when developed side effects, median (range), ng/mL | 13.8 (2–65.6) |
| Infection | Yes (17); 11 bacterial infections (1 osteomyelitis, 2 abscess, 1 tonsillitis, 1 UTI, 3 sepsis, 3 PEG site infection [2 progressed to cellulitis]; 2 viral + bacterial infection (1 influenza A + UTI; 1 chickenpox + cellulitis); 2 viral infections (1 EBV, 1 chickenpox); 2 uncertain etiology (1 recurrent UTI, 1 self-resolved fever) |
| No (5) | |
| Other side effects | Diarrhea (3; 1 with blood in stools) |
| Hyperglycemia (2) | |
| Improved after stopping sirolimus (1) | |
| Developed DM (1) [20] | |
| Difficult healing after extravasation injury (1) | |
| Reasons sirolimus was stopped | Infection (12) |
| Other (5) | |
| Hyperglycemia (2) | |
| Responded to lanreotide (2) | |
| Persistent diarrhea with increased calprotectin (1) | |
| Weaned off until stopped because of concerns for long-term side effects (1) | |
| Remains on it (1) |
Abbreviations: DM, diabetes mellitus; EBV, Epstein-Barr virus; PEG, percutaneous endoscopic gastrostomy; UTI, urinary tract infection.