A Case of 5-Fluorouracil Induced Encephalopathy.
- Author:
Kyung A KWON
1
;
Hyuk Chan KWON
;
Min Chan KIM
;
Sung Hyun KIM
;
Sung Yong OH
;
Suee LEE
;
Hyo Jin KIM
Author Information
1. Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea. kimhj@dau.ac.kr
- Publication Type:Case Report
- Keywords:
5-FU;
Neurotoxicity;
Encephalopathy
- MeSH:
Adult;
Ammonia;
Brain;
Chemotherapy, Adjuvant;
Cisplatin;
Dihydrouracil Dehydrogenase (NADP);
Enema;
Female;
Fluorouracil;
Gastrectomy;
Humans;
Lactulose;
Magnetic Resonance Spectroscopy;
Paranoid Disorders;
Retention (Psychology);
Thiamine
- From:Cancer Research and Treatment
2010;42(2):118-120
- CountryRepublic of Korea
- Language:English
-
Abstract:
Patients with reduced dihydropyrimidine dehydrogenase (DPD) activity are at risk for experiencing serious adverse effects following 5-fluorouracil (5-FU) based chemotherapy. Neurotoxicity is considered an extremely rare side effect of 5-FU. We report here on an unusual case of 5-FU induced encephalopathy. A 38-year-old woman with advanced gastric carcinoma was treated with adjuvant chemotherapy that consisted of infused 5-FU (1,000 mg/m2) for 5 days and cisplatin (60 mg/m2) on day 1 following total gastrectomy. Nineteen days after starting chemotherapy, the patient displayed a sudden onset of slurred speech, confusion, cognitive disturbances and paranoia. A magnetic resonance image (MRI) of the brain showed no structural abnormalities, and the other laboratory tests provided no explanations for her symptoms, other than a slightly elevated ammonia level. The patient was treated with a lactulose retention enema and thiamine infusion, the 5-FU was halted and her symptoms then recovered after 7 days.
