内容紹介
A Case of Lacrimal Duct Obstruction Caused by Capecitabine
Summary
In recent years, the incidence of adverse ocular reactions, including corneal problems and lacrimal duct obstruction, due to antineoplastic agents such as S-1 has increased. Very few reports of adverse ocular reactions caused by capecitabine, a fluorinated pyrimidine antineoplastic agent like S-1, exist, and consequently, the mechanism underlying these reactions is not well understood. This report describes our recent experience with a case of lacrimal duct obstruction caused by capecitabine. The patient was a 71-year-old woman who was being administered trastuzumab plus capecitabine combination chemotherapy for breast cancer-related bone metastasis. She complained of epiphora 7 days after capecitabine was initiated. Thereafter, her capecitabine dose was reduced owing to exacerbation of hand-foot syndrome, but the epiphora persisted. Capecitabine was discontinued 287 days after initiation owing to exacerbation of the hand-foot syndrome. However, because the epiphora persisted, the patient visited the ophthalmology department. The ophthalmologist diagnosed the patient with binocular nasolacrimal duct obstruction and cataract, and prescribed a 0.3% gatifloxacin ophthalmic solution and 0.1% fluorometholone ophthalmic suspension. Thereafter, the epiphora reduced. When the patient returned to the ophthalmology department, symptom improvement was confirmed. In this case, lacrimal duct obstruction likely developed due to capecitabine. The symptoms were reversible with discontinuation of capecitabine and ophthalmic treatment. We believe that reporting this case could be valuable in discussing capecitabine-induced lacrimal duct obstruction.
要旨
近年,S-1に代表されるように抗悪性腫瘍薬による角膜障害や涙道障害などの眼部の有害事象が問題となっている。capecitabineはS-1と同様にフッ化ピリミジン系の抗悪性腫瘍薬であるが,眼部の有害事象に関する報告は極めて少なく,詳細は明らかになっていないのが現状である。今回,capecitabineにより涙道障害が認められた症例を経験したので報告する。患者は71歳,女性。乳がん骨転移の治療のためtrastuzumab+capecitabine療法が行われており,capecitabine開始7日後から流涙の訴えがあった。その後,capecitabineは手足症候群の増悪により休薬および減量されたが,流涙は継続していた。capecitabineは開始から287日後に手足症候群の増悪が原因で中止となったが,流涙が増強していたため患者は眼科を受診した。眼科医の診断結果は両眼鼻涙管閉塞および両眼白内障であり,gatifloxacin点眼液0.3%およびfluorometholone点眼液0.1%が処方された。その後,流涙は軽減し,眼科再診の結果,症状の改善が確認された。本症例ではcapecitabineの投与が原因と考えられる涙道障害が発現した。その症状は可逆的であり,capecitabineの中止および眼科的治療により改善した。本症例は今後,capecitabineの涙道障害を議論する上での貴重な報告になり得ると考えられる。
目次
Summary
In recent years, the incidence of adverse ocular reactions, including corneal problems and lacrimal duct obstruction, due to antineoplastic agents such as S-1 has increased. Very few reports of adverse ocular reactions caused by capecitabine, a fluorinated pyrimidine antineoplastic agent like S-1, exist, and consequently, the mechanism underlying these reactions is not well understood. This report describes our recent experience with a case of lacrimal duct obstruction caused by capecitabine. The patient was a 71-year-old woman who was being administered trastuzumab plus capecitabine combination chemotherapy for breast cancer-related bone metastasis. She complained of epiphora 7 days after capecitabine was initiated. Thereafter, her capecitabine dose was reduced owing to exacerbation of hand-foot syndrome, but the epiphora persisted. Capecitabine was discontinued 287 days after initiation owing to exacerbation of the hand-foot syndrome. However, because the epiphora persisted, the patient visited the ophthalmology department. The ophthalmologist diagnosed the patient with binocular nasolacrimal duct obstruction and cataract, and prescribed a 0.3% gatifloxacin ophthalmic solution and 0.1% fluorometholone ophthalmic suspension. Thereafter, the epiphora reduced. When the patient returned to the ophthalmology department, symptom improvement was confirmed. In this case, lacrimal duct obstruction likely developed due to capecitabine. The symptoms were reversible with discontinuation of capecitabine and ophthalmic treatment. We believe that reporting this case could be valuable in discussing capecitabine-induced lacrimal duct obstruction.
要旨
近年,S-1に代表されるように抗悪性腫瘍薬による角膜障害や涙道障害などの眼部の有害事象が問題となっている。capecitabineはS-1と同様にフッ化ピリミジン系の抗悪性腫瘍薬であるが,眼部の有害事象に関する報告は極めて少なく,詳細は明らかになっていないのが現状である。今回,capecitabineにより涙道障害が認められた症例を経験したので報告する。患者は71歳,女性。乳がん骨転移の治療のためtrastuzumab+capecitabine療法が行われており,capecitabine開始7日後から流涙の訴えがあった。その後,capecitabineは手足症候群の増悪により休薬および減量されたが,流涙は継続していた。capecitabineは開始から287日後に手足症候群の増悪が原因で中止となったが,流涙が増強していたため患者は眼科を受診した。眼科医の診断結果は両眼鼻涙管閉塞および両眼白内障であり,gatifloxacin点眼液0.3%およびfluorometholone点眼液0.1%が処方された。その後,流涙は軽減し,眼科再診の結果,症状の改善が確認された。本症例ではcapecitabineの投与が原因と考えられる涙道障害が発現した。その症状は可逆的であり,capecitabineの中止および眼科的治療により改善した。本症例は今後,capecitabineの涙道障害を議論する上での貴重な報告になり得ると考えられる。