Optic neuropathy in cancer patients. Report of a case possibly related to 5 fluorouracil toxicity and review of the literature.
We report the case of a 72-year-old woman suffering from bone metastatic breast cancer and treated with continuous intravenous 5 fluorouracil (5FU) chemotherapy, who presented with a bilateral asymmetric anterior optic neuropathy (ON). A deficiency of dihydropyrimidine dehydrogenase (DPD) was documented. Patients with DPD deficiency are at increased risk for developing unusual and/or severe toxicity to 5FU. We discuss the differential diagnosis of anterior ON and we suggest that 5FU can be responsible for optic nerve toxicity in patients with DPD deficiency.
Delval
L
L
Service de Médecine Interne et Laboratoire d'Investigations Cliniques, Centre des Tumeurs de l'Université Libre de Bruxelles, Bruxelles, Belgique. ldelval@swing.be
Klastersky
J
J
D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000556:secondary; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects*; D006801:Humans; D009901:Optic Nerve Diseases / Q000139:chemically induced*; D014794:Visual Fields / Q000187:drug effects
D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil