Kilickap Saadettin, Ozdamar Yasemin, Altundag M Kadri, Dizdar Omer
Department of Oncology, Hacettepe University Institute of Oncology, 06100-Sihhiye, Ankara, Turkey.
Med Oncol. 2008;25(2):238-40. doi: 10.1007/s12032-007-9006-2. Epub 2007 Sep 8.
Bisphosphonates prevent bone loss by binding on active sites of bone remodeling and inhibiting osteoclast-mediated bone resorption. Zoledronic acid is recommended for patients with bone metastases from breast, prostate, and lung cancers.
To report a case of anterior uveitis after the infusion of zoledronic acid.
A breast cancer patient with bone metastasis was admitted with pain, visual loss, hyperemia, and periorbital swelling in her right eye 24 h after the first dose of zoledronic acid. Biomicroscopic anterior segment examination of the right eye showed corneal keratic precipitates, ciliary injection, and moderate amount of cells in anterior chamber. With the diagnosis of right anterior uveitis, topical prednisolone acetate (1%) was started, and her symptoms completely resolved within 1 week. Use of the Naranjo probability scale indicated a probable relationship between uveitis and zoledronic acid therapy in our patient.
Uveitis is a rare complication of zoledronic acid. The mechanism is unclear. Proinflammatory cytokines such as TNF-alpha and IL-6 may also play a role in pathogenesis of zoledronic acid-related uveitis.
Zoledronic acid may be associated with inflammatory eye diseases and result in serious ocular damage.
双膦酸盐通过结合骨重塑的活性位点并抑制破骨细胞介导的骨吸收来预防骨质流失。唑来膦酸被推荐用于患有乳腺癌、前列腺癌和肺癌骨转移的患者。
报告一例输注唑来膦酸后发生前葡萄膜炎的病例。
一名患有骨转移的乳腺癌患者在首次注射唑来膦酸24小时后，因右眼疼痛、视力丧失、充血和眶周肿胀入院。右眼生物显微镜前段检查显示角膜后沉着物、睫状充血和前房中等量细胞。诊断为右前葡萄膜炎后，开始局部使用醋酸泼尼松龙（1%），患者症状在1周内完全缓解。使用纳兰霍概率量表表明我们的患者葡萄膜炎与唑来膦酸治疗之间可能存在关联。
葡萄膜炎是唑来膦酸罕见的并发症。其机制尚不清楚。促炎细胞因子如肿瘤坏死因子-α和白细胞介素-6可能在唑来膦酸相关性葡萄膜炎的发病机制中也起作用。
唑来膦酸可能与炎性眼病有关，并导致严重的眼部损害。
