A case of 5-fluorouracil induced encephalopathy.

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.

• Authors: Kyung A Kwon, Hyuk-Chan Kwon, Min Chan Kim, Sung-Hyun Kim, Sung Yong Oh, Suee Lee, Hyo-Jin Kim
• Journal: Cancer research and treatment (Cancer Res Treat) Vol. 42 Issue 2 Pg. 118-20 (Jun 2010) ISSN: 2005-9256 [Electronic] Korea (South)
• PMID: 20622967 (Publication Type: Journal Article)