A case of idiosyncratic liver injury after oxaliplatin-induced thrombocytopenia

J Clin Pharm Ther. 2020 Apr;45(2):373-375. doi: 10.1111/jcpt.13068. Epub 2019 Oct 31.

Abstract

What is known and objective: Oxaliplatin is a platinum drug used for treating digestive cancers that can lead to drug-induced thrombocytopenia (DITP). We report a case of oxaliplatin-induced anaphylaxis and DITP, complicated by idiosyncratic drug-induced liver injury (IDILI).

Case summary: A 46-year-old woman with rectal cancer developed anaphylaxis shortly after oxaliplatin administration (post-operative CapeOX), presenting with low platelet count (0.2 × 104 /µL) and elevated aspartate aminotransferase (1091 IU/L) and alanine aminotransferase (1010 IU/L) by day 10. Following 50 mg/d prednisolone administration from day 9, she left the hospital on day 36 after recovering.

What is new and conclusion: This is the first case report of oxaliplatin-induced IDILI and its effective treatment with steroids.

Keywords: CapeOX; drug-induced thrombocytopenia; idiosyncratic drug-induced liver injury; oxaliplatin.

Publication types

  • Case Reports

MeSH terms

  • Anaphylaxis / chemically induced
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Chemical and Drug Induced Liver Injury / drug therapy
  • Chemical and Drug Induced Liver Injury / etiology*
  • Female
  • Glucocorticoids / administration & dosage
  • Humans
  • Middle Aged
  • Oxaliplatin / administration & dosage
  • Oxaliplatin / adverse effects*
  • Prednisolone / administration & dosage
  • Rectal Neoplasms / drug therapy
  • Thrombocytopenia / chemically induced*

Substances

  • Glucocorticoids
  • Oxaliplatin
  • Prednisolone