目的:介绍了4例依鲁替尼相关性葡萄膜炎,据我们所知,这是文献中的第一个。探讨了依鲁替尼介导的葡萄膜炎的可能机制。
方法:病例1是一名60岁的女性,在伊布替尼治疗慢性淋巴细胞白血病1年后病情稳定。她被诊断出患有伊布替尼相关性葡萄膜炎,对局部类固醇反应良好。病例2是一名63岁的男性,在依鲁替尼治疗慢性淋巴细胞白血病2年后被诊断为葡萄膜炎。他对局部和口服类固醇反应良好;然而,他在断奶类固醇后继续复发葡萄膜炎。病例3是一名69岁的男性,在依鲁替尼治疗18个月后被诊断患有葡萄膜炎。他接受了局部和静脉注射类固醇的试验,并重新启动伊布替尼,症状没有恶化。病例4是一名66岁的女性,在依鲁替尼稳定3年后出现葡萄膜炎。她对局部类固醇反应良好。
结论:酪氨酸激酶抑制剂的炎症并发症已得到充分描述。而伊布替尼,和其他激酶抑制剂,通常耐受性良好,关于眼部毒性的报道越来越多,包括葡萄膜炎.建议监测患者潜在的眼部不良反应,并促进快速眼科评估。
OBJECTIVE: Four cases of ibrutinib-related uveitis are presented, which are to the best of our knowledge the first in the literature. Possible mechanisms of ibrutinib-mediated uveitis are explored.
METHODS: Case 1 is a 60-year-old female who had been stable on 1 year of ibrutinib for chronic lymphocytic leukaemia. She was diagnosed with ibrutinib-related uveitis, which responded well to topical steroids.
Case 2 is a 63-year-old male diagnosed with uveitis after 2 years of ibrutinib treatment for chronic lymphocytic leukaemia. He responded well to topical and oral steroids; however, he continued to have uveitis relapses after weaning steroids.
Case 3 is a 69-year-old male diagnosed with uveitis after 18 months of ibrutinib treatment. He was trialed on topical and intravenous steroids, and restarted ibrutinib without worsening of symptoms.
Case 4 is a 66-year-old female who developed uveitis after being stable on ibrutinib for 3 years. She responded well to topical steroids.
CONCLUSIONS: Inflammatory complications of tyrosine kinase inhibitors are well described. While ibrutinib, and other kinase inhibitors, are generally well-tolerated, there are increasing
reports of ocular toxicities, including uveitis. It is recommended to monitor patients for potential ocular adverse effects and facilitate rapid ophthalmologic assessment.