Optic neuritis associated with sunitinib
- PDF / 1,998,933 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 5 Downloads / 208 Views
LETTER TO THE EDITOR
Optic neuritis associated with sunitinib Seunghee Na 1 & Taewon Kim 1 Received: 14 June 2020 / Accepted: 7 September 2020 # Fondazione Società Italiana di Neurologia 2020
Introduction Sunitinib malate is a receptor tyrosine kinase inhibitor commonly used to control angiogenesis and proliferation in cancer. Fatigue, gastrointestinal symptoms, hypertension, and myelosuppression are common adverse effects of sunitinib and are usually manageable. Although adverse neurological effects associated with sunitinib are rare [1], serious and unexpectable adverse reactions can be seen with widespread use of targeted anticancer therapies. Herein, we describe a rare case of optic neuritis (ON) in a patient with metastatic renal cell carcinoma treated with sunitinib.
Case report A 60-year-old man presented with blurry vision and ocular pain in the right eye, which had progressed over the past 7 days. He had been previously diagnosed with renal cell carcinoma with pulmonary and skin (foot) metastasis (clear cell carcinoma, T3N0M1) and was taking antihypertensive and anti-diabetes drugs. He had been prescribed 50 mg/day of sunitinib 1 month before but had discontinued the medication due to severe nausea after 2 days. One month later, he was prescribed 37.5 mg of sunitinib again. There were no other newly administered drugs. The patient adhered to the sunitinib regimen for 9 days until he developed progressive ocular pain, blurry vision, and scotoma of the nasal field in the right eye. Although he immediately visited the oncologist and stopped taking sunitinib, these symptoms persisted. Upon neurologic examination, the pupils were isocoric and reactive to light. The patient’s visual acuity was 20/40 in the right eye and 20/25 in the left eye. An Ishihara test revealed 17/17 in both * Taewon Kim [email protected] 1
Department of Neurology, College of Medicine, Incheon St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea
eyes, and fundoscopy showed a swollen optic disc and focal retinal hemorrhage in the right eye (Fig. 1a). Other cranial nerves were normal. Laboratory examinations including Creactive protein, rapid plasma reagin, anti-Sjögren’s syndrome–related antigens A and B (anti-Ro, La), antineutrophil cytoplasmic antibody, anti-double-stranded DNA antibody, antiphospholipid antibody, serum IgG4, fluorescent antinuclear antibody, C3, C4, protein electrophoresis, and immunofixation electrophoresis levels were within normal limits. Aquaphorin-4 and myelin oligodendrocyte glycoprotein (MOG) antibodies were not detected. The full-field visual evoked potential (VEP) test was performed using a pattern reversal of a black and white checkboard (check size 15 min of arc, at a frequency of 3 Hz). The VEP test showed a delayed right P100 latency at 124 msec while left P100 latency was 110 msec. The optical coherence tomography (OCT) showed optic disc edema and increased thickness of the retinal nerve fiber layer (RNFL) in the right eye. Brain magnetic resonance imaging revealed normal b
Data Loading...
