Ocular cicatricial pemphigoid following Dipeptidyl Peptidase-4 inhibitor use: A case report

PurposeTo report a rare Ocular Cicatricial Pemphigoid (OCP) case in a patient taking a Dipeptidyl Peptidase-4 Inhibitor (DPP-4 inhibitor), a medication used for the management of type 2 diabetes, for at least six years.ObservationsA 64-year-old male presented with refractory bilateral conjunctival i...

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Bibliographic Details
Published in:American journal of ophthalmology case reports 2023, Vol.32, p.101957-101957
Main Authors: Matsumoto, Akifumi, Fukuoka, Hideki, Yoneda, Akiko, Yokoi, Norihiko, Sotozono, Chie
Format: Report
Language:English
Online Access:Get full text
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Summary:PurposeTo report a rare Ocular Cicatricial Pemphigoid (OCP) case in a patient taking a Dipeptidyl Peptidase-4 Inhibitor (DPP-4 inhibitor), a medication used for the management of type 2 diabetes, for at least six years.ObservationsA 64-year-old male presented with refractory bilateral conjunctival inflammation and ocular discharge that had persisted for two months, despite multiple prior therapies for presumed bacterial conjunctivitis. Upon initial examination, clinical findings strongly suggested OCP, and he had elevated levels of anti-BP180 antibodies. Despite receiving systemic treatments such as steroid pulse therapy and therapeutic plasma exchange after discontinuing DPP-4 inhibitors, his condition progressively worsened, with manifestations such as forniceal shortening in his left eye. Consequently, the patient required keratoepithelioplasty, amniotic membrane transplantation in his left eye, and bilateral eyelid entropion surgery. His condition initially worsened for a time after discontinuing the DPP-4 inhibitor, but it gradually improved over time, and ocular surface surgical intervention was not required in the right eye.Conclusions and ImportanceThe findings in this study demonstrate that severe refractory OCP may occur while taking the DPP-4 inhibitor, thus indicating that a detailed interview regarding medications is essential for patients with ocular pemphigoid, especially those with type 2 diabetes.
ISSN:2451-9936
DOI:10.1016/j.ajoc.2023.101957