[A Case Altered Consciousness Due to 5-Fluorouracil-Induced Hyperammonemia in a Patient with Recurrent Colorectal Cancer].

Abstract

We report a case of altered consciousness related to hyperammonemia due to FOLFIRI plus bevacizumab therapy in a patient with recurrent colorectal cancer and renal dysfunction.A 76-year-old man received third-line chemotherapy for left mediastinal lymph node metastasis.He complained of diarrhea on the evening of the same day, and mental confusion on day 3 of the first FOLFIRI therapy.He had a JCS of Ⅲ(200).The laboratory results revealed a marked hyperammonemia.5 - fluorouracil(5-FU)-induced hyperammonemia was diagnosed and the patient was ventilated and managed with branchedchain amino acid solutions, lactulose, and hemodialysis in the ICU.After hemodialysis, the blood ammonia level reduced to the normal limits, and the symptoms of encephalopathy resolved on the following day.He was discharged home on the 19th day of hospitalization.5 -FU-containing therapy should be carefully administered in patients with renal dysfunction.Herein, we report a case of 5-FU-induced hyperammonemia with literature considerations.

• Authors: Sho Sawazaki, Masakatsu Numata, Mihwa Ju, Junya Morita, Keisuke Komori, Yukio Maezawa, Shinya Amano, Toru Aoyama, Hiroshi Tamagawa, Tsutomu Sato, Takashi Oshima, Hiroyuki Mushiake, Norio Yukawa, Munetaka Masuda, Yasushi Rino
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 46 Issue 10 Pg. 1632-1634 (Oct 2019) ISSN: 0385-0684 [Print] Japan
• PMID: 31631158 (Publication Type: Case Reports, Journal Article)

Chemical References

• Leucovorin
• Fluorouracil
• Camptothecin

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols
• Camptothecin
• Colorectal Neoplasms
• Consciousness
• Fluorouracil (adverse effects)
• Humans
• Hyperammonemia (chemically induced)
• Leucovorin
• Male
• Neoplasm Recurrence, Local