[A case of recurrent gastric cancer with dihydropyrimidine dehydrogenase (DPD) deficiency].

Abstract

Dihydropyrimidine dehydrogenase (DPD) is a reducing enzyme for fluoropyrimidine which is a widely-used anti-cancer agent, and its deficiency leads to serious toxicities. We report a rare patient with a DPD deficiency. A 39-year-old man was suspected to have a gastric cancer recurrence from the elevation of CEA. Although TS-1 was administered for five days, it was stopped due to the development of grade 2 anorexia and nausea. Although we administered UFT at his request after a one-month drug rest, grade 1 stomatorrhagia besides the former adverse events developed after five days. Therefore he discontinued it and was admitted to our hospital. After 19 days, he died from multiple brain hemorrhage despite the intensive therapies. We considered that the congenital DPD deficiency caused the development of these adverse events because the DPD value was less than 5 pmol/mg/min in mononuclear cells of peripheral blood.

• Authors: Tatsuya Hashimoto, Kuniyoshi Arai, Yoshiaki Iwasaki, Zenichiro Saze, Keiichi Takahashi, Tatsuro Yamaguchi, Hiroshi Matsumoto, Michiya Yasutome, Kiyoshi Hiruma, Yuichi Yamashita
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 33 Issue 7 Pg. 985-8 (Jul 2006) ISSN: 0385-0684 [Print] Japan
• PMID: 16835493 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antimetabolites, Antineoplastic
• Drug Combinations
• UFT(R) drug
• S 1 (combination)
• Tegafur
• Uracil
• Oxonic Acid

Topics

• Adult
• Anorexia (chemically induced)
• Antimetabolites, Antineoplastic (administration & dosage, adverse effects)
• Bone Neoplasms (secondary)
• Cerebral Hemorrhage (etiology)
• Dihydropyrimidine Dehydrogenase Deficiency
• Drug Combinations
• Fatal Outcome
• Humans
• Liver Neoplasms (secondary)
• Male
• Nausea (chemically induced)
• Oxonic Acid (administration & dosage, adverse effects)
• Stomach Neoplasms (drug therapy, enzymology, pathology)
• Tegafur (administration & dosage, adverse effects)
• Uracil (administration & dosage, adverse effects)