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Drug-Induced Liver Injury Caused by Capecitabine: A Case Report and a Literature Review
Chemotherapy is widely used in cancer treatment, and the drug Capecitabine is often used in treatment of breast cancer and usually well-tolerated. Toxicity from Capecitabine typically involves hand-foot syndrome, fatigue, nausea, reduced appetite, and diarrhea, while severe liver toxicity is rarely...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
S. Karger AG
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293942/ https://www.ncbi.nlm.nih.gov/pubmed/37384198 http://dx.doi.org/10.1159/000529866 |
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author | Hussein, Miriam Jensen, Anders Bonde |
author_facet | Hussein, Miriam Jensen, Anders Bonde |
author_sort | Hussein, Miriam |
collection | PubMed |
description | Chemotherapy is widely used in cancer treatment, and the drug Capecitabine is often used in treatment of breast cancer and usually well-tolerated. Toxicity from Capecitabine typically involves hand-foot syndrome, fatigue, nausea, reduced appetite, and diarrhea, while severe liver toxicity is rarely seen. We present a case of a 63-year-old female with metastatic breast cancer, without liver metastasis, who developed a severe drug-induced liver injury (DILI) with critically elevated liver enzyme levels as reaction to Capecitabine treatment with seemingly no evident explanation as to why. The patient had a RUCAM score of 7 and a Naranjo score of 6 implying that this association between Capecitabine and the liver injury falls into the “probable” category. The patient recovered completely and was then successfully treated with other cytotoxic drugs without any sign of liver engagement. An in-depth literature search based on Pubmed database was performed to obtain information about Capecitabine, liver injury, and chemotherapy-associated acute hepatic toxicity. The following keywords were used: Capecitabine, chemotherapy, liver toxicity, and hepatic toxicity. Five studies were found showing some similarities to this case documenting hepatic injury after Capecitabine treatment including hepatic steatosis and moderately elevated liver enzymes. However, no studies were found reporting a severe DILI with highly elevated enzyme levels as immediate response to Capecitabine treatment. No reason could be identified as for why the patient developed an acute toxic liver reaction to Capecitabine. This case calls for more attention to the potential severe liver toxicity of an otherwise well-tolerated drug. |
format | Online Article Text |
id | pubmed-10293942 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | S. Karger AG |
record_format | MEDLINE/PubMed |
spelling | pubmed-102939422023-06-28 Drug-Induced Liver Injury Caused by Capecitabine: A Case Report and a Literature Review Hussein, Miriam Jensen, Anders Bonde Case Rep Oncol Case Report Chemotherapy is widely used in cancer treatment, and the drug Capecitabine is often used in treatment of breast cancer and usually well-tolerated. Toxicity from Capecitabine typically involves hand-foot syndrome, fatigue, nausea, reduced appetite, and diarrhea, while severe liver toxicity is rarely seen. We present a case of a 63-year-old female with metastatic breast cancer, without liver metastasis, who developed a severe drug-induced liver injury (DILI) with critically elevated liver enzyme levels as reaction to Capecitabine treatment with seemingly no evident explanation as to why. The patient had a RUCAM score of 7 and a Naranjo score of 6 implying that this association between Capecitabine and the liver injury falls into the “probable” category. The patient recovered completely and was then successfully treated with other cytotoxic drugs without any sign of liver engagement. An in-depth literature search based on Pubmed database was performed to obtain information about Capecitabine, liver injury, and chemotherapy-associated acute hepatic toxicity. The following keywords were used: Capecitabine, chemotherapy, liver toxicity, and hepatic toxicity. Five studies were found showing some similarities to this case documenting hepatic injury after Capecitabine treatment including hepatic steatosis and moderately elevated liver enzymes. However, no studies were found reporting a severe DILI with highly elevated enzyme levels as immediate response to Capecitabine treatment. No reason could be identified as for why the patient developed an acute toxic liver reaction to Capecitabine. This case calls for more attention to the potential severe liver toxicity of an otherwise well-tolerated drug. S. Karger AG 2023-05-24 /pmc/articles/PMC10293942/ /pubmed/37384198 http://dx.doi.org/10.1159/000529866 Text en © 2023 The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission. |
spellingShingle | Case Report Hussein, Miriam Jensen, Anders Bonde Drug-Induced Liver Injury Caused by Capecitabine: A Case Report and a Literature Review |
title | Drug-Induced Liver Injury Caused by Capecitabine: A Case Report and a Literature Review |
title_full | Drug-Induced Liver Injury Caused by Capecitabine: A Case Report and a Literature Review |
title_fullStr | Drug-Induced Liver Injury Caused by Capecitabine: A Case Report and a Literature Review |
title_full_unstemmed | Drug-Induced Liver Injury Caused by Capecitabine: A Case Report and a Literature Review |
title_short | Drug-Induced Liver Injury Caused by Capecitabine: A Case Report and a Literature Review |
title_sort | drug-induced liver injury caused by capecitabine: a case report and a literature review |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10293942/ https://www.ncbi.nlm.nih.gov/pubmed/37384198 http://dx.doi.org/10.1159/000529866 |
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