5-FU multifocal inflammatory leukoencephalopathy and dihydropyrimidine dehydrogenase deficiency.
Multifocal inflammatory leukoencephalopathy (MIL) is a cerebral demyelinating syndrome that develops after chemotherapy with 5-fluorouracil (5-FU) and levamisole. The authors report a patient who developed MIL after 5-FU administration not in association with levamisole. She was subsequently diagnosed with partial deficiency of dihydropyrimidine dehydrogenase, an enzyme necessary for 5-FU catabolism. The authors suggest that MIL is a direct result of 5-FU chemotherapy and that patients with dihydropyrimidine dehydrogenase deficiency are at increased risk for this and other toxic effects of 5-FU.
Franco
D A
DA
Department of Neurology, University of Michigan Medical Center, Ann Arbor, USA.
Greenberg
H S
HS
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000009:adverse effects; D016190:Carboplatin / Q000009:adverse effects; D042943:Dihydrouracil Dehydrogenase (NADP); D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D006801:Humans; D007968:Leukoencephalopathy, Progressive Multifocal / Q000139:chemically induced* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging; D010088:Oxidoreductases / Q000172:deficiency*
D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D016190:Carboplatin; D010088:Oxidoreductases; D042943:Dihydrouracil Dehydrogenase (NADP); D005472:Fluorouracil