title: [Two cases of hyperammonemic patients treated by chemotherapy for colorectal cancer].
abstract: We report two patients having hyperammonemic encephalopathy while being treated with chemotherapy for colorectal cancer. The first patient was a 69-year-old man with sigmoid colon cancer, having a massive invasion to the urinary bladder. He received SOX therapy following a pelvic exenteration operation. After the third course of SOX therapy, he presented with general fatigue and repeated seizures, and blood examination showed a high level of serum ammonium. He was diagnosed as hyperammonemic encephalopathy. The second patients was a 60-year-old woman with ascending colon cancer and liver metastasis having portal vein tumor thrombosis, who was given a palliative resection of ascending colon, and then underwent modified FOLFOX6 therapy. At the second course, she fell into a deep coma, and blood examination revealed a high level of serum ammonium. In both patients, treatment with infusion of branched-chain amino acid solutions resolved the symptoms of encephalopathy. Acute neurotoxicity caused by hyperammonemic encephalopathy during chemotherapy for colorectal cancer is rare and not well recognized, but it is a clinically important complication. We should pay more attention to hyperammonemic encephalopathy of patients receiving chemotherapy for colorectal cancer.
authors.affiliation: Department of Surgery, Ohta Nishinouchi Hospital.
authors.forename: Arihiro
authors.initials: A
authors.lastname: Aihara
authors.forename: Muga
authors.initials: M
authors.lastname: Terasawa
authors.forename: Soichi
authors.initials: S
authors.lastname: Furukawa
authors.forename: Reo
authors.initials: R
authors.lastname: Kasai
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Ito
authors.forename: Takanori
authors.initials: T
authors.lastname: Ochiai
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kumagai
authors.forename: Michio
authors.initials: M
authors.lastname: Iida
authors.forename: Shigeru
authors.initials: S
authors.lastname: Yamazaki
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D022124:Hyperammonemia / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging
chemical_list: D000970:Antineoplastic Agents