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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...

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Autores principales: Hussein, Miriam, Jensen, Anders Bonde
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2023
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.
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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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