title: A case of 5-fluorouracil induced encephalopathy.
abstract: Patients with reduced dihydropyrimidine dehydrogenase (DPD) activity are at risk for experiencing serious adverse effects following 5-fluorouracil (5-FU) based chemotherapy. Neurotoxicity is considered an extremely rare side effect of 5-FU. We report here on an unusual case of 5-FU induced encephalopathy. A 38-year-old woman with advanced gastric carcinoma was treated with adjuvant chemotherapy that consisted of infused 5-FU (1,000 mg/m²) for 5 days and cisplatin (60 mg/m²) on day 1 following total gastrectomy. Nineteen days after starting chemotherapy, the patient displayed a sudden onset of slurred speech, confusion, cognitive disturbances and paranoia. A magnetic resonance image (MRI) of the brain showed no structural abnormalities, and the other laboratory tests provided no explanations for her symptoms, other than a slightly elevated ammonia level. The patient was treated with a lactulose retention enema and thiamine infusion, the 5-FU was halted and her symptoms then recovered after 7 days.
authors.affiliation: Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Kyung A
authors.initials: KA
authors.lastname: Kwon
authors.forename: Hyuk-Chan
authors.initials: HC
authors.lastname: Kwon
authors.forename: Min Chan
authors.initials: MC
authors.lastname: Kim
authors.forename: Sung-Hyun
authors.initials: SH
authors.lastname: Kim
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Oh
authors.forename: Suee
authors.initials: S
authors.lastname: Lee
authors.forename: Hyo-Jin
authors.initials: HJ
authors.lastname: Kim