Bilateral Secondary Angle Closure During Daratumumab Infusion: A Case Report and Review of the Literature.
Edwards Rebecca G, Vanderhoof Shawna, Palestine Alan, Seibold Leonard K
AI Summary
Daratumumab can cause bilateral acute secondary angle closure from choroidal effusions. Clinicians must recognize this rare, vision-threatening side effect for prompt intervention.
Abstract
Daratumumab is an anti-CD38 monoclonal antibody approved for use in multiple myeloma in 2015 and under investigation for use in light-chain amyloidosis. We report a case of a patient with amyloidosis who developed bilateral, acute secondary angle closure during an infusion of daratumumab. Ultrasound biomicroscopy obtained 3 days after the onset of her symptoms demonstrated the cause to be bilateral choroidal effusions. Taken together with several previous case reports, the evidence suggests that, like topiramate, daratumumab is associated with the idiosyncratic reaction of choroidal effusions, resulting in a spectrum of clinical outcomes from myopic shift to acute angle closure. The treating oncologist and eye care provider should be aware of these adverse outcomes in any patient undergoing treatment with this medication, as swift recognition and intervention may be vision-saving.
MeSH Terms
Shields Classification
Key Concepts5
A patient with amyloidosis developed bilateral, acute secondary angle closure during an infusion of daratumumab.
Ultrasound biomicroscopy obtained 3 days after the onset of symptoms in a patient with amyloidosis who developed bilateral, acute secondary angle closure during daratumumab infusion demonstrated the cause to be bilateral choroidal effusions.
Evidence from a case report and several previous case reports suggests that daratumumab, like topiramate, is associated with the idiosyncratic reaction of choroidal effusions, resulting in a spectrum of clinical outcomes from myopic shift to acute angle closure.
Swift recognition and intervention of adverse outcomes such as choroidal effusions and acute angle closure associated with daratumumab treatment may be vision-saving.
Daratumumab, an anti-CD38 monoclonal antibody, is approved for use in multiple myeloma since 2015 and is under investigation for use in light-chain amyloidosis.
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