We had previously reported on S-1-induced
hypertriglyceridemia. Here, we report
fluorouracil-induced
hypertriglyceridemia in a patient with
capecitabine-induced
hypertriglyceridemia and the corresponding therapeutic process. A woman in her forties who had experienced grade 3
hypertriglyceridemia due to
oxaliplatin +
capecitabine was administered
fluorouracil ±
oxaliplatin + levofolinate
calcium +
panitumumab; however, grade 4
hypertriglyceridemia occurred after the thirteenth administration.
Bezafibrate normalized the elevation.
Chemotherapy cessation resulted in its decrease to normal, and
bezafibrate was stopped. Nine months after cessation, treatment with
fluorouracil +
irinotecan + levofolinate
calcium +
ramucirumab was initiated. After four cycles of treatment, her serum
triglyceride levels increased again to grade 3, and then,
fenofibrate was administered, resulting in a significant decrease to grade 1-2. Serum
triglyceride levels significantly reduced after cessation of the prior
fluorouracil-containing regimen, although its elevation was observed again following the latter treatment. Therefore,
fluorouracil-induced
hypertriglyceridemia was strongly speculated in this case. We have speculated that the most probable cause of
tegafur and
capecitabine-induced
hypertriglyceridemia is
fluorouracil or its metabolic
enzymes since their end product is
fluorouracil in the previous report. Results from this patient suggest that our supposition was correct.
Fibrates administration, cessation of the treatment, and monitoring of serum
triglyceride level was effective in this case as well as previous reports.
Fluorouracil-induced
hypertriglyceridemia is associated with the one caused by
tegafur and
capecitabine and presents the possibility of severe complications. Elucidation of its exact mechanism and epidemiological features is needed for better understanding.