Severe hypertriglyceridemia induced by everolimus in a lung transplant patient: case report

Introduction -mTOR inhibitors (e.g., everolimus) are increasingly used post-transplant to reduce calcineurin inhibitor nephrotoxicity but can cause severe dyslipidemia, including marked hypertriglyceridemia with pancreatitis risk.1 Case presentation -A 64-year-old man with type 2 diabetes, chronic obstructive pulmonary disease (COPD) with pleiomorphic giant-cell carcinoma resected underwent left single-lung transplantation in March 2023.Everolimus was introduced on April 9, 2025 to spare calcineurin inhibitors in the setting of worsening renal function requiring dialysis.Triglycerides rose from 256 mg/dL (March 24, 2022) to 2886 mg/dL (August 5, 2025) and 4960 mg/dL (September 16, 2025).Everolimus was replaced by mycophenolate mofetil on September 26, 2025, with TG falling to 2000 mg/dL (September 29, 2025) and 300 mg/dL (November 3, 2025).Interventions -Discontinuation of everolimus and switch to mycophenolate mofetil; continuation of pravastatin; dietary measures.Outcomes -Rapid triglycerides reduction after stopping everolimus; no acute pancreatitis documented in the available data.Conclusion -This case highlights everolimus-associated hypertriglyceridemia in a lung transplant recipient and underscores the need for tight lipid monitoring and early immunosuppression adjustment when severe dyslipidemia emerges.