Lee Brian A, Lee Michael S, Maltry Amanda C, Hou Joshua H
Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, MN.
Cornea. 2018 May 23. doi: 10.1097/ICO.0000000000001635.
To report the first histological characterization of microcyst-like epithelial keratopathy (MEK) associated with depatuxizumab mafodotin (ABT-414).
Case report.
A 35-year-old man with glioblastoma multiforme participating in a phase III trial of the antibody-drug conjugate ABT-414 developed a large corneal abrasion from complications of MEK. Confocal imaging showed multiple large, round, hyperreflective lesions. Epithelial debridement was performed. Immunohistochemistry of the diseased epithelium showed IgG-positive granular cytoplasmic inclusions and increased cell apoptosis. With discontinuation of topical steroids, frequent lubrication, bandage contact lenses, and reduction in dose to maintenance therapy, the patient experienced symptomatic improvement. However, the MEK lesions recurred after debridement.
ABT-414 accumulates in the basal corneal epithelium resulting in MEK due to increased apoptosis. Frequent lubrication and bandage contact lenses can provide symptom relief.
报告与地帕妥珠单抗马福多汀(ABT - 414)相关的微囊肿样上皮性角膜病变(MEK)的首次组织学特征。
病例报告。
一名35岁多形性胶质母细胞瘤男性患者参与抗体药物偶联物ABT - 414的III期试验,因MEK并发症出现大面积角膜擦伤。共聚焦成像显示多个大的、圆形、高反射性病变。进行了上皮清创术。病变上皮的免疫组织化学显示IgG阳性颗粒状细胞质内含物和细胞凋亡增加。随着局部类固醇停用、频繁润滑、使用绷带式隐形眼镜以及剂量减至维持治疗,患者症状有所改善。然而,清创术后MEK病变复发。
ABT - 414积聚在角膜基底上皮中,由于细胞凋亡增加导致MEK。频繁润滑和使用绷带式隐形眼镜可缓解症状。