• PDF / 170,721 Bytes
• 1 Pages / 595.245 x 841.846 pts (A4) Page_size
• 52 Downloads / 153 Views

DOWNLOAD

REPORT

---

1 S

Dexamethasone/temozolomide Hepatic toxicity and haematological toxicity: case report

A 55-year-old man developed hepatic toxicity and haematological toxicity during treatment with dexamethasone and temozolomide for glioblastoma [dosages not stated; not all routes stated]. The man was diagnosed with a left temporo-insuloparietla left tumour following occurrence of focal cognitive seizures with expressive aphasia or complex visual hallucinations. He therefore underwent a partial tumour resection, which resulted in persistent conduction aphasia, characterised by a slight difficulty repeating and naming everyday objects, with literal paraphasic errors. The resected tumour was diagnosed as glioblastoma. Due to increase in seizure frequency, followed by aphasic exacerbation, which included inability to understand language, he received treatment with levetiracetam and sodium valproate until complete response. He started receiving chemotherapy with temozolomide along with radiotherapy and subsequent six cycles of adjuvant temozolomide, according to the STUPP protocol. An initial good radiological response was noted. While receiving his first adjuvant chemotherapy cycle, he was admitted in the emergency room, desperately screaming due to acute and excruciating pain on the right arm and ipsilateral face, which was described as shock-like and stabbing [aetiology not stated]. Each episode lasted a few seconds, but had been repeating in cluster for over an hour. Thus, he additionally received lacosamide, which resulted in the resolution of painful complaint within a few minutes. He continued to receive subsequent treatment with lacosamide. A few days later, he was found to have local tumour recurrence. After being discharged, he continued treatment regimen with lacosamide, levetiracetam and sodium valproate, along with oral temozolomide and dexamethasone. He was found to have a very mild tumour growing, concurrent with the development of the right hemiparesis with brachial predominance [aetiology not stated for right hemiparesis]. The dose of sodium valproate was reduced thereafter [reason for dose decrease not stated]. Though, he did not have seizures, he developed hepatic and haematological toxicity, which was determined to be induced by chemothereapy (temozolomide and dexamethasone) [durations of treatments to reactions onsets not stated]. The man died 7 months after hospital discharge due to infectious complications [aetiology not stated for the infectious complications]. Garcez D, et al. Paroxysmal pain as the only presentation of focal epilepsy. Clinical Case Reports 8: 1971-1973, No. 10, Oct 2020. Available from: URL: http:// doi.org/10.1002/ccr3.3143

0114-9954/20/1830-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

803515309

Reactions 14 Nov 2020 No. 1830