title: [A case of hyperammonemic encephalopathy in a patient with recurrent colon cancer treated with modified FOLFOX6].
abstract: FOLFOX therapy is a commonly used chemotherapeutic regimen against recurrent and unresectable colon cancer. However, its acute neurotoxicity is rare and not well recognized. We herein report a case of mFOLFOX6-induced hyperammonemic encephalopathy in a patient having recurrent colon cancer. A 74-year-old female with a history of sigmoid colon cancer was diagnosed as liver, lung, and peritoneal recurrences by surveillance CT and PET/CT. She was initially treated with modified FOLFOX6 therapy. After completing treatment, she presented with sudden onset of confusion, cognitive disturbances, and repeated seizures. None of the other radiographic examinations and laboratory tests provided an explanation for her symptoms except hyperammonemia. She was treated with branched-chain amino acid solutions and high-volume drip infusion, 6 hours after which the encephalopathy resolved. Clinicians should be aware of the adverse hyperammonemia induced by mFOLFOX6 when patients treated with mFOLFOX6 present with neurological disorders.
authors.affiliation: Chikuba Hospital for Proctological and Gastrointestinal Diseases.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Teraishi
authors.forename: Takeo
authors.initials: T
authors.lastname: Suzuki
authors.forename: Masako
authors.initials: M
authors.lastname: Nakamoto
authors.forename: Akira
authors.initials: A
authors.lastname: Chikuba
authors.forename: Masashi
authors.initials: M
authors.lastname: Nezu
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimamura
authors.forename: Takamasa
authors.initials: T
authors.lastname: Watanabe
authors.forename: Tadakazu
authors.initials: T
authors.lastname: Matsuda
authors.forename: Takao
authors.initials: T
authors.lastname: Takiue
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Chikuba
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001928:Brain Diseases, Metabolic / Q000097:blood* / Q000139:chemically induced* / Q000473:pathology; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D022124:Hyperammonemia / Q000097:blood* / Q000139:chemically induced*; D002955:Leucovorin / Q000627:therapeutic use; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D049268:Positron-Emission Tomography; D012008:Recurrence; D014057:Tomography, X-Ray Computed
chemical_list: D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil