Erlotinib-related bilateral anterior uveitis

Abstract

The authors report the case of a 68-year-old woman with secondary adenocarcinoma of the lungs from an unknown primary. Erlotinib was started which produced symptoms suggestive of uveitis. Erlotinib was stopped and restarted a month later at a lower dose, which resulted in severe bilateral anterior uveitis. The uveitis settled after stopping erlotinib and treatment with topical steroids and cycloplegics. To the best of the authors' knowledge, this is the first case of erlotinib-related anterior uveitis.

Follow-up of erlotinib related uveitis

“…Ocular side effects are rare and include conjunctivitis, trichomegaly and keratoconjunctivitis 2–5. A recent addition to this list is non-granulomatous uveitis 1. No further symptoms of uveitis seem to suggest that the previously experienced uveitis may have been related to erlotinib.…”

Bilateral acute anterior uveitis: a rare ocular side effect of erlotinib

“…This patient developed bilateral painful red eyes managed as conjunctivitis for 3 weeks before erlotinib was ceased due to development of fevers 9 10. The patient described subsequent improvement of ocular symptoms while off erlotinib but with relapse of these when recommenced on erlotinib at a dose reduction 9 10. At this point she was referred to ophthalmologist who diagnosed the patient with bilateral AAU 9 10.…”

“…Thus, drug-induced bilateral AAU is a rare entity. Four cases of erlotinib-associated AAU have been reported since 2010 8–11. The first reported case of bilateral AAU attributable to erlotinib reported in 2010 was of a 63-year-old woman in Glasgow, with no significant medical history apart from advanced NSCLC 8.…”

“…She was treated with topical ocular steroids and mydriatics for 2 weeks with resolution of the AAU and synechiae; no mention was made of interruption of erlotinib treatment 8. The second case was reported in 2011 and involved a 68-year-old woman in Liverpool with NSCLC treated with erlotinib 9 10. This patient developed bilateral painful red eyes managed as conjunctivitis for 3 weeks before erlotinib was ceased due to development of fevers 9 10.…”

“…The second case was reported in 2011 and involved a 68-year-old woman in Liverpool with NSCLC treated with erlotinib 9 10. This patient developed bilateral painful red eyes managed as conjunctivitis for 3 weeks before erlotinib was ceased due to development of fevers 9 10. The patient described subsequent improvement of ocular symptoms while off erlotinib but with relapse of these when recommenced on erlotinib at a dose reduction 9 10.…”