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Romanian Journal of Internal Medicine

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Drug Induced Lupus Erythematosus Due to Capecitabine and Bevacizumab Treatment Presenting with Prolonged Thrombocytopenia

Ersin Ozaslan
  • Department of Medical Oncology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
/ Eray Eroglu
  • Department of Internal Medicine, Erciyes University, Faculty of Medicine, Kayseri, Turkey
/ Kevser Gok
  • Department of Rheumatology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
/ Soner Senel
  • Department of Rheumatology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
/ Suleyman Baldane
  • Corresponding author
  • Department of Internal Medicine, Selcuk University, Faculty of Medicine, Konya, Turkey
  • Email:
/ Lutfi Akyol
  • Department of Rheumatology, Ondokuz Mayıs University, Faculty of Medicine, Samsun, Turkey
/ Metin Ozkan
  • Department of Medical Oncology, Erciyes University, Faculty of Medicine, Kayseri, Turkey
Published Online: 2015-10-14 | DOI: https://doi.org/10.1515/rjim-2015-0037


Drug induced lupus erythematosus (DILE) is a syndrome that is formed by lupus-like symptoms and laboratory characteristics. Capecitabine is an orally administered tumor-selective fluoropyrimidine that acts as a prodrug of 5-Fluorouracil and bevacizumab is an antivascular endothelial growth factor (anti-VEGF) antibody, both are used for the treatment of patients with colorectal cancer. Herein we report the first case of DILE in a 68-year-old woman who presented with arthralgia, myalgia and prolonged thrombocytopenia after receiving capecitabine and bevacizumab combination treatment as palliative treatment for metastatic colon cancer. Platelet levels were increased and joint complaints disappeared in the first week of hydroxychloroquine and methylprednisolone treatment after chemotherapy had been discontinued. In conclusion, physicians should be alert to the possibility of DILE in patients presenting with thrombocytopenia under a capecitabine and bevacizumab chemotherapy regimen.

Lupusul eritematos indus medicamentos (DILE) este un sindrom caracterizat prin simptome lupus-like şi modificări paraclinice caracteristice. Capecitabinul este un anti-tumoral selectiv din clasa fluoropirimidinelor administrat oral şi acţionează ca un prodrog al 5-Fluorouracilului. Bevacizumabul este un anticorp monoclonal îndreptat împotriva factorului de creştere vascular endotelial (VEGF). Ambele medicamente sunt utile în tratamentul cancerului colorectal. Prezentăm un caz clinic al unei paciente în vârstă de 68 de ani care după administrarea capecitabinului şi a bevacizumabului drept tratament paleativ pentru cancer metastatic colorectal a dezvoltat artralgii, mialgii şi trombocitopenie prelungită. Artralgiile au dispărut şi numărul trombocitelor a crescut după oprirea medicaţiei şi administrarea timp de o săptămână a hidroxiclorochinului şi a metilprednisolonului. În concluzie, medicii ar trebui să fie atenţi la posibilitatea dezvoltării DILE la pacienţii ce se prezintă cu trombocitopenie atunci când le este administrată terapia cu capecitabină şi bevacizumab.

Keywords: capecitabine; drug induced lupus erythematosus; thrombocytopenia


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About the article

Received: 2015-05-01

Published Online: 2015-10-14

Published in Print: 2015-09-01

Citation Information: Romanian Journal Of Internal Medicine, ISSN (Online) 1220-4749, DOI: https://doi.org/10.1515/rjim-2015-0037. Export Citation

© 2015 Ersin Ozaslan et al., published by De Gruyter Open. This chapter is distributed under the terms of the Creative Commons Attribution 4.0 Public License. (CC BY 4.0)

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