Four cases of transient hyperammonemic encephalopathy following continuous infusion of 5-fluorouracil.
- Author:
Kyung Kee BAEK
1
;
Sung Hea KIM
;
Seung Tai KIM
;
Do Hyoung LIM
;
Sang Hoon JI
;
Joon Oh PARK
;
Won Ki KANG
Author Information
1. Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. oncopark@smc.samsung.co.kr
- Publication Type:Case Report
- Keywords:
5-Fluorouracil;
Hyperammonemia;
Encephalopathy
- MeSH:
Ammonium Compounds;
Diagnosis, Differential;
Diarrhea;
Drug Therapy;
Enema;
Fluorouracil*;
Humans;
Hyperammonemia;
Lactulose;
Mucositis
- From:Korean Journal of Medicine
2004;67(5):545-550
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
5-Fluorouracil (5-FU) is a chemotherapeutic agent commonly used in the treatment of a variety of solid tumors. Common adverse effects of fluorouracil chemotherapy include diarrhea, mucositis and myelosuppression. However, neurologic toxicities including hyperammonemic encephalopathy are rare and not well recognized. Transient hyperammonemic encephalopathy related to continuous infusion of high-dose 5-FU has rarely been reported. We report four cases of transient hyperammonemic encephalopathy in patients receiving continuous infusion of 5-FU. The mentality of all patients was altered during or just after the infusion of 5-FU. There were no focal neurological signs, laboratory excluding hyperammonemia or radiological abnormalities. After patients received adequate hydration and repeated lactulose enema, the mental status completely recovered within one or two days, and serum ammonium level subsequently returned to normal. In conclusion, we suggest that a transient hyperammonemic encephalopathy should be considered in differential diagnosis of patients receiving continuous 5-FU infusion with altered mentality.
