5-fluorouracil의 지속적인 주입 후 발생한 일시적 고암모니아성 뇌병증 4예
Four cases of transient hyperammonemic encephalopathy following continuous infusion of 5-fluorouracil
백경기, 김성해, 김승태, 임도형, 지상훈, 박준오, 강원기,
소속 상세정보
백경기 ( Baek Kyung-Kee )
성균관대학교 의과대학 삼성서울병원 내과
김성해 ( Kim Sung-Hea )
성균관대학교 의과대학 삼성서울병원 내과
김승태 ( Kim Seung-Tai )
성균관대학교 의과대학 삼성서울병원 내과
임도형 ( Lim Do-Hyoung )
성균관대학교 의과대학 삼성서울병원 내과
지상훈 ( Ji Sang-Hoon )
성균관대학교 의과대학 삼성서울병원 내과
박준오 ( Park Joon-Oh )
성균관대학교 의과대학 삼성서울병원 내과
강원기 ( Kang Won-Ki )
성균관대학교 의과대학 삼성서울병원 내과
KMID : 0882420040670050545
Abstract
5-Fluorouracil (5-FU) is a chemotherapeutic agent commonly used in the treatment of a variety of solid tumors. Common adverse effects of fluorouracil chemotherapy include diarrhea, mucositis and myelosuppression. However, neurologic toxicities including hyperammonemic encephalopathy are rare and not well recognized. Transient hyperammonemic encephalopathy related to continuous infusion of high-dose 5-FU has rarely been reported. We report four cases of transient hyperammonemic encephalopathy in patients receiving continuous infusion of 5-FU. The mentality of all patients was altered during or just after the infusion of 5-FU. There were no focal neurological signs, laboratory excluding hyperammonemia or radiological abnormalities. After patients received adequate hydration and repeated lactulose enema, the mental status completely recovered within one or two days, and serum ammonium level subsequently returned to normal. In conclusion, we suggest that a transient hyperammonemic encephalopathy should be considered in differential diagnosis of patients receiving continuous 5-FU infusion with altered mentality.
키워드
5-Fluorouracil;Hyperammonemia;Encephalopathy
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