Spontaneous healing of corneal perforation after temporary discontinuation of erlotinib treatment.
Spontaneous healing of corneal perforation after temporary discontinuation of erlotinib treatment.
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DOI：
10.1159/000358082
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发表时间：
2014-01
影响因子：
0.4
通讯作者：
Sonoda KH
中科院分区：
文献类型：
--
作者：
Morishige N;Hatabe N;Morita Y;Yamada N;Kimura K;Sonoda KH
目的：报告1例因口服厄洛替尼引起的角膜穿孔，并在暂时停止药物治疗后自行愈合。一位65岁的男性转移性肺癌患者接受了厄洛替尼(150 mg/天)的治疗，厄洛替尼是一种表皮生长因子受体的特异性酪氨酸激酶抑制剂。他被推荐到我们的角膜服务中心治疗双侧角膜疾病，被诊断为轻度缺水干眼，并通过插入点状塞子进行治疗。他的角膜上皮病变最初有所改善，但后来恶化，表现为右眼出现双侧角膜溃疡并角膜穿孔。术后中断口服厄洛替尼，为角膜移植做准备，但术后2天右眼角膜穿孔及双眼上皮缺损均自行愈合。埃洛替尼的治疗恢复到最初剂量的一半，双眼角膜显然保持健康。厄洛替尼可能会分泌到泪液中，从而对角膜上皮产生不利影响。接受这种药物的患者的角膜上皮疾病的发展可以通过减少剂量来逆转。
To report a case of corneal perforation associated with oral administration of erlotinib and its spontaneous healing after temporary discontinuation of drug treatment. A 65-year-old man with metastatic lung cancer was treated with erlotinib (150 mg/day), a specific tyrosine kinase inhibitor of the epidermal growth factor receptor. He was referred to our corneal service for the treatment of bilateral corneal disorders, diagnosed with mild aqueous-deficient dry eye, and treated by insertion of punctal plugs. His corneal epithelial disorders initially improved, but subsequently worsened, as manifested by the development of bilateral corneal ulceration with corneal perforation in the right eye. The oral administration of erlotinib was interrupted in preparation for tectonic keratoplasty, but 2 days later the corneal perforation of the right eye and the bilateral epithelial defects had healed spontaneously. Treatment with erlotinib was resumed at half the initial dose, and the cornea of both eyes has remained apparently healthy. Erlotinib may be secreted into tear fluid and thereby adversely affect the corneal epithelium. The development of corneal epithelial disorders in patients receiving this drug may be reversed by reducing its dose.