Volume 22, Issue 1 e13072
CASE REPORT

Everolimus-associated perianal ulcers in an eight-month-old heart transplant recipient

Marco S. Spehl

Corresponding Author

Marco S. Spehl

Department of Congenital Heart Defects and Pediatric Cardiology, Heart Center, University of Freiburg, Freiburg, Germany

Correspondence

Marco Spehl, Department of Congenital Heart Defects and Pediatric Cardiology, Heart Center, University of Freiburg, Germany.

Email: [email protected]

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Thilo Fleck

Thilo Fleck

Department of Congenital Heart Defects and Pediatric Cardiology, Heart Center, University of Freiburg, Freiburg, Germany

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Franziska Schauer

Franziska Schauer

Department of Dermatology, Medical Center – University of Freiburg, Freiburg, Germany

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Frank Meiss

Frank Meiss

Department of Dermatology, Medical Center – University of Freiburg, Freiburg, Germany

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Brigitte Stiller

Brigitte Stiller

Department of Congenital Heart Defects and Pediatric Cardiology, Heart Center, University of Freiburg, Freiburg, Germany

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First published: 24 October 2017
Citations: 4

Abstract

mTOR inhibitors have a wide spectrum of therapeutic applications in adults and children. Little is known, however, about serious adverse effects in children undergoing mTOR inhibitor therapy. Oral ulcers are common and sometimes severe, but no other gastrointestinal involvement has been reported so far. Here we present a case of everolimus-associated perianal ulcers in an eight-month-old infant, 3 months after heart transplantation, which necessitated the drug's discontinuation. In a thorough series of diagnostic tests, we identified no other cause for the progressive perianal ulceration. The recognition and appropriate management of mTOR inhibitors' adverse effects in pediatric patients are essential and remain challenging.

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