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Vol.61 No.2 contents | Japanese/English |
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- Case Report -
A Case of Pulmonary Adenocarcinoma with Repeated Corneal Epithelial Disorder and Herpes Simplex due to Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors
Shinichi Iwamoto1, Tadashi Igishi1, Toru Kadowaki1, Yusuke Tsubouchi1, Emiko Nishikawa1, Mitsuhiro Tada1, Masahiro Kimura1, Kanako Kobayashi1, Toshikazu Ikeda11Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Japan
Background. Drug-induced lung injury, skin rashes, and diarrhea are known adverse effects of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Corneal epithelial disorder and herpes simplex are rarely encountered in association with EGFR-TKIs. Case. A 69-year-old woman was admitted to our hospital for further evaluation of an abnormal shadow on chest radiography. Chest computed tomography (CT) showed a nodule on the right S8. Adenocarcinoma with the EGFR L858R mutation was diagnosed via transbronchial lung biopsy. We made a diagnosis of cT1bN0M1b stage IV with brain metastasis and administered erlotinib. On the 5th day, she developed herpes simplex on the left lower jaw area. She was treated with valacyclovir. On the 11th day, her visual acuity deteriorated, and she was diagnosed with bicorneal epithelitis and bikeratitis. A detailed history confirmed a history of corneal detachment of unknown cause, suggesting corneal fragility. After the discontinuation of erlotinib, her corneal epithelial opacity gradually improved. When gefitinib was administered, her visual acuity deteriorated again in the afternoon of the same day. Herpes simplex recurred on her lips. On the next day, the ophthalmology department diagnosed a relapse of corneal epithelial opacity. After the discontinuation of gefitinib, her corneal epithelial opacity gradually improved. Conclusion. Corneal epithelial disorder and herpes simplex were considered to be adverse effects of EGFR-TKIs since re-administration caused the same disorder.
key words: Lung carcinoma, Epidermal growth factor receptor tyrosine kinase inhibitor, Corneal epithelial disorder, Herpes simplex
Received: November 13, 2020
Accepted: December 28, 2020
JJLC 61 (2): 125-129, 2021
