title: [A case of sclerosing cholangitis caused by oral chemotherapy with S-1].
abstract: We report a case of sclerosing cholangitis caused by oral chemotherapy with S-1. A 79-year-old woman with a history of hypertension presented with epigastric discomfort. Upper gastrointestinal endoscopy revealed advanced gastric cancer in the gastric antrum and abdominal computed tomography showed multiple lymph node metastasis. The patient underwent chemotherapy with S-1. Since 2 months later, blood chemistry analysis showed liver dysfunction and hyperbilirubinemia, and chemotherapy was discontinued. Endoscopic retrograde cholangiopancreatography revealed stenosis of the bile duct at the hepatic hilum. There was no evidence of tumor in the liver. We diagnosed chemotherapy-induced sclerosing cholangitis (CISC) caused by S-1. Although treatment with ursodeoxycholic acid and corticosteroids was temporarily effective, she eventually died of CISC and gastric cancer. To the best of our knowledge, this is the first case report of CISC caused by S-1. We present this rare condition with a review of the literature.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Biomedical Science, Nagasaki University, Japan. t_msaki@hotmail.co.jp
authors.forename: Tomohito
authors.initials: T
authors.lastname: Morisaki
authors.forename: Ken
authors.initials: K
authors.lastname: Ohnita
authors.forename: Fuminao
authors.initials: F
authors.lastname: Takeshima
authors.forename: Yuko
authors.initials: Y
authors.lastname: Akazawa
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Yamaguchi
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Miyaaki
authors.forename: Naohiro
authors.initials: N
authors.lastname: Taura
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Hajime
authors.initials: H
authors.lastname: Isomoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Toriyama
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects*; D015209:Cholangitis, Sclerosing / Q000139:chemically induced*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D010094:Oxonic Acid / Q000009:adverse effects*; D013274:Stomach Neoplasms / Q000188:drug therapy*; D005641:Tegafur / Q000009:adverse effects*
chemical_list: D000964:Antimetabolites, Antineoplastic; D004338:Drug Combinations; C079198:S 1 (combination); D005641:Tegafur; D010094:Oxonic Acid