title: [A case of portal hypertension after 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) chemotherapy].
abstract: A 46-year-old man with cancer of the sigmoid colon with hepatic metastasis underwent sigmoidectomy, partial hepatectomy, and cholecystectomy in May 2008. He subsequently received 10 cycles of a modified 5-fluorouracil, leucovorin, and oxaliplatin (mFOLFOX6) regimen as adjuvant chemotherapy from June 2008 to December 2008, following which he developed thrombocytopenia and splenomegaly. In May 2011, upper gastrointestinal endoscopy was performed, which revealed esophageal and gastric varices. The varices were treated endoscopically with ligation and balloon-occluded retrograde transvenous obliteration. A liver biopsy was performed to determine the cause of the portal hypertension in the absence of severe hepatic dysfunction or liver cirrhosis. The biopsy revealed obliteration of the peripheral portal veins with sinusoidal dilatation without fibrosis or inflammatory cell infiltration in the hepatic lobules. Oxaliplatin-based chemotherapy has been associated with hepatovascular injury, such as sinusoidal dilatation and fibrosis, resulting in non-cirrhotic portal hypertension as seen in this case.
authors.affiliation: Department of Hepatology, Hamanomachi Hospital.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ogata
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Gushima
authors.forename: Shinko
authors.initials: S
authors.lastname: Maruoka
authors.forename: Satoko
authors.initials: S
authors.lastname: Takasaki
authors.forename: Risa
authors.initials: R
authors.lastname: Tanaka
authors.forename: Takashi
authors.initials: T
authors.lastname: Matsuura
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D005472:Fluorouracil / Q000008:administration & dosage; D006801:Humans; D006975:Hypertension, Portal / Q000139:chemically induced*; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D012811:Sigmoid Neoplasms / Q000188:drug therapy
chemical_list: D000964:Antimetabolites, Antineoplastic; D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil