title: A Case of Hyperammonemia Associated with High Dihydropyrimidine Dehydrogenase Activity.
abstract: Over the past decades, 5-Fluorouracil (5-FU) has been widely used to treat several types of carcinoma, including esophageal squamous cell carcinoma. In addition to its common side effects, including diarrhea, mucositis, neutropenia, and anemia, 5-FU treatment has also been reported to cause hyperammonemia. However, the exact mechanism responsible for 5-FU-induced hyperammonemia remains unknown. We encountered an esophageal carcinoma patient who developed hyperammonemia when receiving 5-FU-containing chemotherapy but did not exhibit any of the other common adverse effects of 5-FU treatment. At the onset of hyperammonemia, laboratory tests revealed high dihydropyrimidine dehydrogenase (DPD) activity and rapid 5-FU clearance. Our findings suggested that 5-FU hypermetabolism may be one of the key mechanisms responsible for hyperammonemia during 5-FU treatment.
authors.affiliation: Department of Hematology and Oncology, Suzuka General Hospital, Yamanohana, Yasuzuka, Suzuka, Mie Prefecture 1275-53, Japan.
authors.forename: Keiki
authors.initials: K
authors.lastname: Nagaharu
authors.affiliation: Department of Pharmacy, Mie University Hospital, Edobashi 2-174, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikemura
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Oda
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Mikiya
authors.initials: M
authors.lastname: Ishihara
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Tamaru
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Toshiro
authors.initials: T
authors.lastname: Mizuno
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie Prefecture 514-8507, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Katayama