エルロチニブ塩酸塩（タルセバ®）内服中にみられた角膜潰瘍

Corneal ulcer in a case during systemic treatment with erlotinib hydrochloride

要約　背景：エルロチニブ塩酸塩（タルセバ^®）は細胞増殖を抑制する薬物で，切除が不能な肺癌などに経口投与される。目的：エルロチニブ塩酸塩の服用中に角膜潰瘍，捷毛の長毛化や乱生が生じた症例の報告。症例：87歳男性が両眼の角膜潰瘍で紹介受診した。肺腺癌に対してエルロチニブ塩酸塩を6か月前から内服中であった。所見：両眼に角膜潰瘍と，捷毛の長生化と乱生があった。オフロキサシン眼軟膏とレボフロキサシン点眼は奏効せず，初診の5日後にエルロチニブ塩酸塩の服用を中止した。その23日後に角膜潰瘍は治癒した。以後9か月後の現在まで経過は良好である。結論：本症例の角膜潰瘍は，エルロチニブ塩酸塩による角膜上皮障害と捷毛乱生とが原因であったと推定される。

Abstract.　Background：Erlotinib hydrochloride suppresses proliferation of cells and is given perorally to cases of lung carcinoma that cannot be excised. Purpose：To report a case who developed corneal ulcer, trichiasis and trichomegaly during peroral treatment with erlotinib hydrochloride. Case：An 87-year-old male was referred to us for corneal ulcer in both eyes. He had been treated with erlotinib hydrochlorise perorally for lung carcinoma since 6 months before. Findings：Both eyes showed corneal ulcer, trichiasis and trichomegaly. Corneal ulcer failed to improve after topical treatment with antibiotics. Peroral erlotinib was discontinued 5 days after his initial visit. Corneal ulcer cured 23 days after discontinuation. He has been doing well for 9 months until present. Conclusion：Corneal ulcer in the present case was presumably secondary to trichiasis and to impaired corneal epithelium by erlotinib hydrochloride.