内容紹介
A Case of Metastatic Colorectal Cancer with Hyperammonemic Encephalopathy Induced by 5-FU in a Patient Continuously Treated with XELOX Therapy
Summary
We report a rare case of a patient with metastatic colorectal cancer who experienced hyperammonemic encephalopathy induced by 5-fluorouracil(5-FU)and was continuously treated with capecitabine plus oxaliplatin(XELOX)therapy. A 60 years man with anorexia and weight loss was diagnosed with Stage Ⅳ rectal cancer, and chemotherapy with XELOX was initiated. When the second course of XELOX therapy was administered, the patient found it difficult to take oral capecitabine. Subsequently, modified FOLFOX6 was administered. Complications such as nausea and vomiting were observed on day 2, with confusion and cognitive disturbances on day 3. Laboratory examination revealed hyperammonemia, and therefore, branched-chain amino acid solutions were administered as treatment. The patient's symptoms disappeared entirely on day 4. He is currently receiving XELOX therapy.
要旨
5-FUが原因と考えられる高アンモニア血症を来した切除不能大腸癌に対して,XELOX療法を継続し得た1例を経験したので報告する。症例は60歳代,男性。食欲不振,体重減少で当院を受診し,Stage Ⅳの直腸癌と診断された。切除不能であり,XELOX療法を導入した。2コース終了時にcapecitabineの内服が困難との訴えがありmFOLFOX6療法に変更したところ,2日目に悪心・嘔吐,3日目に意識障害が出現した。血液生化学検査で高アンモニア血症を認めたため,分枝鎖アミノ酸製剤投与を行い,翌日には症状は改善した。その後は再度XELOX療法を施行し,現在も継続中である。
目次
Summary
We report a rare case of a patient with metastatic colorectal cancer who experienced hyperammonemic encephalopathy induced by 5-fluorouracil(5-FU)and was continuously treated with capecitabine plus oxaliplatin(XELOX)therapy. A 60 years man with anorexia and weight loss was diagnosed with Stage Ⅳ rectal cancer, and chemotherapy with XELOX was initiated. When the second course of XELOX therapy was administered, the patient found it difficult to take oral capecitabine. Subsequently, modified FOLFOX6 was administered. Complications such as nausea and vomiting were observed on day 2, with confusion and cognitive disturbances on day 3. Laboratory examination revealed hyperammonemia, and therefore, branched-chain amino acid solutions were administered as treatment. The patient's symptoms disappeared entirely on day 4. He is currently receiving XELOX therapy.
要旨
5-FUが原因と考えられる高アンモニア血症を来した切除不能大腸癌に対して,XELOX療法を継続し得た1例を経験したので報告する。症例は60歳代,男性。食欲不振,体重減少で当院を受診し,Stage Ⅳの直腸癌と診断された。切除不能であり,XELOX療法を導入した。2コース終了時にcapecitabineの内服が困難との訴えがありmFOLFOX6療法に変更したところ,2日目に悪心・嘔吐,3日目に意識障害が出現した。血液生化学検査で高アンモニア血症を認めたため,分枝鎖アミノ酸製剤投与を行い,翌日には症状は改善した。その後は再度XELOX療法を施行し,現在も継続中である。