Lethal toxicity after 5-fluorouracil chemotherapy and its possible relationship to dihydropyrimidine dehydrogenase deficiency: a case report and review of the literature.

Abstract

5-fluorouracil (5-FU) is a chemotherapeutic agent widely used in the treatment of solid malignancies, especially in colorectal cancer. A characteristic note seen with its use is the considerable interindividual variation in the incidence and severity of the toxicities seen among patients. We report the case of a 55-year old woman who presented with severe, lethal toxicity to standard doses of 5-fluorouracil (5-FU) and folinic acid. We discuss the known clinical determinants of toxicity. We also discuss the possible molecular factors implicated in the variable toxicity seen to 5-FU, especially in regards to dihiyropyrimidine dehydrogenase, a pivotal enzyme in the metabolism of 5-FU.

• Authors: R Díaz, A Segura, J Aparicio, V Calderero, A Guerrero, L Pellín
• Journal: Journal of chemotherapy (Florence, Italy) (J Chemother) Vol. 16 Issue 6 Pg. 599-603 (Dec 2004) ISSN: 1120-009X [Print] England
• PMID: 15700854 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Folic Acid
• Fluorouracil

Topics

• Antimetabolites, Antineoplastic (adverse effects, therapeutic use)
• Colorectal Neoplasms (complications, drug therapy)
• Deficiency Diseases (complications)
• Dihydropyrimidine Dehydrogenase Deficiency
• Fatal Outcome
• Female
• Fluorouracil (adverse effects, therapeutic use)
• Folic Acid (administration & dosage)
• Humans
• Middle Aged