Reporting on Adverse Clinical Events

A 49-year-old female patient developed recurrent left painful parotid swelling and tenderness approximately 4 days after receiving the third of 4 cycles of 2-weekly dose-dense doxorubicin and cyclophosphamide chemotherapy for grade 3 invasive ductal carcinoma. No other medications were noted in this report. A physical examination on emergency room presentation revealed no fever and the absence of infective symptoms. An orthopantomogram ruled out the presence of parotid duct stones or other dental causes for her symptoms. Serological screenings for infectious etiologies were negative. The patient had also experienced temporary bilateral parotitis following the previous 2 cycles of this chemotherapy. She did not experience parotitis after the fourth cycle of chemotherapy. The authors concluded that this patient developed recurrent parotitis related to doxorubicin and cyclophosphamide therapy based on the temporal relationship between the administration of the drugs and the appearance and resolution of symptoms, including a positive rechallenge. According to the Naranjo adverse event causality scale, this reaction was rated as probable in relation to therapy. They noted that this is the first case report of parotitis associated with the combined use of the drugs. Doxorubicin [“Doxorubicin”] Cyclophosphamide [“Cytoxan”] Fox-Lewis A et al (A Fox-Lewis, Department of Palliative Care, Waikato District Health Board, Pembroke Street, Private Bag 3200, Hamilton 3240, New Zealand; e-mail: afoxlewis@gmail.com) Doxorubicin and cyclophosphamide-induced parotitis: a case report. J Clin Pharm Ther 45:211–213 (Feb) 2020