Hypertriglyceridemia and hyperglycemia induced by capecitabine: a report of two cases and review of the literature.
BACKGROUND
Capecitabine is a tumor-activated oral fluoropyrimidine used in breast and colorectal cancer. Hypertriglyceridemia associated with this drug has rarely been reported in the literature.


METHODS
Two patients with colorectal carcinoma who developed capecitabine-induced hypertriglyceridemia (including a patient who developed hyperglycemia concurrently) were described, treatment modalities were discussed, and the literatures were reviewed.


RESULTS
The first patient, a 43-year-old man, developed hyperlipidemia and hyperglycemia after two cycles of XELOX regimen chemotherapy for colorectal cancer. His triglyceride was 2.47 mmol/L (normal range 0.34-1.7 mmol/L) and total cholesterol was 6.93 mmol/L (normal range 3.12-5.9 mmol/L), while blood glucose was abnormal (fasting blood glucose was 10.58-11.9 mmol/L and 2 h postprandial glucose was 14.5-17.2 mmol/L) and glucose was positive in the urine(3+). The second patient, a 47-year-old woman, developed abnormalities in the lipid profile after the sixth cycle of XELOX regimen chemotherapy for colorectal cancer. Her serum triglyceride was 2.41 mmol/L (normal range 0.34-1.7 mmol/L), while the cholesterol level was 7.73 mmol/L (normal range 3.12-5.9 mmol/L). The profile of lipid improved gradually with reduced doses of capecitabine and was well restored after chemotherapy without any lipid-lowering agents. The Naranjo score for capecitabine-induced hypertriglyceridemia was 9 (definite). An analysis of the underlying pathogenic mechanisms was provided.


CONCLUSIONS
It is important of physicians and pharmacists to be aware of the possibility of dyslipidemia, particularly hypertriglyceridemia induced by capecitabine.
Department of Oncology, The People's Hospital of Taizhou, Taizhou Medical School, Jiangsu and Nantong University, Jiangsu, China.
Gao-Hua
GH
Han
Department of Oncology, The People's Hospital of Taizhou, Taizhou Medical School, Jiangsu and Nantong University, Jiangsu, China hjxtz@sina.cn.
Jun-Xing
JX
Huang
D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D001786:Blood Glucose / Q000187:drug effects; D000069287:Capecitabine / Q000008:administration & dosage / Q000009:adverse effects*; D015179:Colorectal Neoplasms / Q000188:drug therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced*; D015228:Hypertriglyceridemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D010071:Oxaloacetates; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D010071:Oxaloacetates; D014280:Triglycerides; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil
Hypertriglyceridemia; capecitabine; colorectal carcinoma; hyperglycemia