[A case of hyperammonemic encephalopathy in a patient with recurrent colon cancer treated with modified FOLFOX6].
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.
Teraishi
Fuminori
F
Chikuba Hospital for Proctological and Gastrointestinal Diseases.
Suzuki
Takeo
T
Nakamoto
Masako
M
Chikuba
Akira
A
Nezu
Masashi
M
Shimamura
Hiroshi
H
Watanabe
Takamasa
T
Matsuda
Tadakazu
T
Takiue
Takao
T
Chikuba
Hiroshi
H
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
D009944:Organoplatinum Compounds; D002955:Leucovorin; D005472:Fluorouracil