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Case Reports: Adverse drug reactions and complications
Capecitabine-induced posterior reversible encephalopathy syndrome (PRES) in a patient with gastric adenocarcinoma
  1. Karim Dirani1,2,
  2. Georgiana Marusca1,
  3. Jing Wang1 and
  4. Daniel Juzych1
  1. 1DMC, Detroit, Michigan, USA
  2. 2Ophthalmology, Kresge Eye Institute, Detroit, Michigan, USA
  1. Correspondence to Dr Georgiana Marusca; fy6522{at}wayne.edu

Abstract

Posterior reversible encephalopathy syndrome (PRES) is characterised by encephalopathy, visual disturbances and seizures, accompanied by radiological parieto-occipital oedema. Immunosuppressive and immunomodulatory drugs are risk factors. While capecitabine-induced PRES cases are rare, this report details a young woman with advanced gastric adenocarcinoma on capecitabine. She exhibited symptoms of nausea, vomiting and abdominal pain before developing hypertension, drowsiness and a seizure. Brain MRI revealed parieto-occipital hyperintense areas indicative of PRES. Suspending capecitabine led to a gradually improved mental state. Prompt recognition and treatment of PRES offer reversibility, often achievable through dose reduction or discontinuation of the causative drug.

  • Cancer - see Oncology
  • Gastrointestinal system

https://doi.org/10.1136/bcr-2022-252059

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    Footnotes

    • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms and critical revision for important intellectual content: KD, GM, JW and DJ. KD wrote and edited the case consistently. I have received support from all the other authors regarding the order of ideas and content edits. GM is the corresponding author. KD, JW and DJ aided in the formatting of the current manuscript—each author drafted their individual segments of the manuscript. GM and JW were responsible for concisely drafting the introduction and case presentation. DJ and KD reviewed the most recent literature on the topic and presented it in the discussion of the manuscript. KD and DJ sourced and edited the associated clinical image. KD, DJ, GM and JW were responsible for critical revision and formatting of the manuscript to fit the template of BMJ Case Reports.The following authors gave final approval of the manuscript: KD, GM, JW and DJ. Is the patient one of the authors of this manuscript? No.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.