에를로티닙과 라파티닙을 사용한 환자에서 발생한 표층점상각막병증
Superficial Punctate Keratoepitheliopathy Under Treatment with Erlotinib and Lapatinib
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목적: 항암 치료로 표피성장인자수용체 억제제(에를로티닙, 라파티닙)를 사용한 환자에서 표층점상각막병증 2예를 경험하여 문헌고찰과 함께 보고하고자 한다. 증례요약: 증례 1은 에를로티닙을 사용한 후 각막접촉이 없는 거대 속눈썹증과 미만성의 표층점상각막병증이 발생하였다. 각막병증은에를로티닙을 중단한 후 호전되었고, 에를로티닙을 다시 사용한 이후 재발하였다. 증례 2는 라파티닙을 사용한 후 속눈썹의 변화없이미만성의 표층점상각막병증이 발생하였다. 두 증례 모두 심각한 시력저하는 없었고, 무방부제인공누액과 자가혈청안약을 사용하고 호전되었다. 결론: 에를로티닙과 라파티닙이 미만성의 표층점상각막병증을 유발한 것으로 생각하고, 점안액 사용으로 호전되었다.
Abstract
Purpose: To report the corneal superficial punctate keratoepitheliopathy in 2 patients taking the epidermal growth factor receptor(EGFR) inhibitors, erlotinib and lapatinib, respectively. Case summary: Case 1, who received erlotinib, showed trichomegaly without touching the cornea and diffuse punctatekeratoepitheliopathy. Corneal epitheliopathy and the corresponding symptoms resolved after discontinuation of the drugthen recurred with reapplication. Case 2 presented diffuse corneal punctate epithelial erosions that developed without anycilia involvement after the patient was administered lapatinib. The visual acuity of both patients was not severely diminishedand keratoepitheliopathy was mostly resolved with the treatment of preservative-free artificial tears and autologousserum eye drops. Conclusions: Erlotinib and lapatinib are both likely to cause visually tolerable corneal punctate keratoepitheliopathy whichcan be resolved with appropriate topical treatment.
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