Ocular immunology and inflammation · 2024
Bilateral Panuveitis After Endometrial Cancer Treatment with Dostarlimab: A Case Report.
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Enríquez-Fuentes Jacobo Emilio, Lorenzo-Castro Jaime, Pascual-Santiago Marco Antonio, Colino-Gallardo Ana María, Arriola-Villalobos Pedro
Аннотация
PURPOSE: To report a case of bilateral panuveitis following Dostarlimab therapy for endometrial cancer.
METHODS: Case report.
RESULTS: A 73-year-old woman with a history of endometrial cancer, previously treated with Dostarlimab (an immune checkpoint inhibitor), presented to the ophthalmology emergency department with decreased visual acuity in her left eye. Her medical history included immune-mediated thyroid involvement, which led to the discontinuation of Dostarlimab. Subsequently, she developed pneumonitis and pancreatitis. On initial examination in the emergency room, she had poor vision (hand motion in the right eye and 20/200 on the Snellen chart in the left eye), an inflammatory reaction in the anterior chamber, with 1+ cells, small keratic precipitates and broad posterior synechiae in both eyes. Examination of the posterior pole revealed 3+ vitritis, which made it difficult to evaluate the retina. Treatment with oral and topical corticosteroids was initiated, resulting in an improvement in symptoms and the resolution of intraocular inflammation in several weeks.
CONCLUSION: Immune checkpoint inhibitors are used in the treatment of various types of cancer, with their efficacy demonstrated in different clinical trials. However, they are also associated with a range of adverse reactions. To date, no ocular adverse reactions related to the use of Dostarlimab have been published. A case of bilateral panuveitis potentially induced by Dostarlimab is described.
METHODS: Case report.
RESULTS: A 73-year-old woman with a history of endometrial cancer, previously treated with Dostarlimab (an immune checkpoint inhibitor), presented to the ophthalmology emergency department with decreased visual acuity in her left eye. Her medical history included immune-mediated thyroid involvement, which led to the discontinuation of Dostarlimab. Subsequently, she developed pneumonitis and pancreatitis. On initial examination in the emergency room, she had poor vision (hand motion in the right eye and 20/200 on the Snellen chart in the left eye), an inflammatory reaction in the anterior chamber, with 1+ cells, small keratic precipitates and broad posterior synechiae in both eyes. Examination of the posterior pole revealed 3+ vitritis, which made it difficult to evaluate the retina. Treatment with oral and topical corticosteroids was initiated, resulting in an improvement in symptoms and the resolution of intraocular inflammation in several weeks.
CONCLUSION: Immune checkpoint inhibitors are used in the treatment of various types of cancer, with their efficacy demonstrated in different clinical trials. However, they are also associated with a range of adverse reactions. To date, no ocular adverse reactions related to the use of Dostarlimab have been published. A case of bilateral panuveitis potentially induced by Dostarlimab is described.