Immunotherapy-Induced Vogt Koyanagi Harada Syndrome: A Case Report
Aref Chehal
Oncology and Hematology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE.
Ashraf Alakkad *
Internal Medicine Department, Madinat Zayed Hospital, AL Dhafra Region, UAE.
Madhava Rao Kenja
Vitreo-retina Unit and the Ophthalmology Department, Burjeel Hospital and VPS Healthcare, UAE.
Ashish Chintakuntlawar
Oncology and Hematology Department, Sheikh Shakhbout Medical City, Abu Dhabi, UAE.
*Author to whom correspondence should be addressed.
Abstract
This report describes a case of Vogt Koyanagi Harada Disease (VKH) in a 44-year-old male with metastatic gastric carcinoma who presented with sudden onset headache and decreased vision. The patient was treated with first-line standard therapy for stage IV HER2-positive gastric adenocarcinoma and was on maintenance trastuzumab and pembrolizumab for seven months before developing new symptoms. His VKH was diagnosed after multiple imaging and a comprehensive ophthalmologic examination. The patient’s vision and headaches improved with theinitiation of corticosteroid therapy. Although immunotherapy wasdiscontinued,trastuzumab was continuedwith close ophthalmology follow-up. He remains in stable conditiondespitehis cancer. It is critical to consider and recognize immunotherapy-relatedophthalmologic complications immediately, even if they are rare, considering theirimplications. Corticosteroids remain the first-line organ-saving therapy.
Keywords: Blurring vision, vogt koyanagi harada disease, pembrolizumab, herceptin