CTICasesEverolimus-Induced Secondary Pulmonary Alveolar Proteinosis
Imaging findings
Serial CT chest scans in a lung transplant recipient show progressive, worsening ground-glass opacities confined to the transplanted lung. Transbronchial biopsy confirmed secondary pulmonary alveolar proteinosis (PAP) and organizing pneumonia. The findings resolved after stopping everolimus.
Key takeaways
Secondary pulmonary alveolar proteinosis (PAP) can be drug-induced. In transplant recipients, mTOR inhibitors (such as everolimus or sirolimus) are known causes of secondary PAP, typically presenting as progressive ground-glass opacities in the graft. Discontinuation of the offending drug leads to clinical and radiographic improvement.
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