Toyokawa Akihiro, Nakajima Takayoshi, Inui Kyoko, Yamashita Hironari, Gon Hidetoshi, Kanemitsu Kiyonori, Tanaka Kenichi, Tsukamoto Tadashi, Hamabe Yutaka, Ishida Takeshi
Dept. of Surgery, Yodogawa Christian Hospital.
Gan To Kagaku Ryoho. 2009 Jul;36(7):1167-9.
A 50-year-old man undergoing operations for sigmoid colon cancer, small intestine invasion, and liver metastasis was given adjuvant chemotherapy postoperatively. During the course, lung, brain and bone metastasis were found, FOLFIRI therapy was started. Fifth FOLFIRI therapy was performed, but on the night of the next day, he was transported on an emergency basis to our hospital because of a coma. Laboratory examination revealed hyperammonemia, so aminoleban was started for its treatment. After 3 days in the hospital, consciousness and serum ammonia were improved. Cases of hyperammonemia caused by 5-FU have been reported in the literature, and this case was diagnosed with the same. Hyperammonemia should be taken into account as a differential diagnosis in the disturbance of consciousness in chemotherapy.
一名50岁男性因乙状结肠癌、小肠侵犯和肝转移接受手术,术后接受辅助化疗。在此过程中,发现了肺、脑和骨转移,遂开始FOLFIRI治疗。进行了第五次FOLFIRI治疗,但在次日夜间,他因昏迷被紧急送往我院。实验室检查显示高氨血症,因此开始使用氨乐补进行治疗。住院3天后,意识和血清氨水平有所改善。文献中曾报道过由5-氟尿嘧啶引起的高氨血症病例,本病例被诊断为同一情况。在化疗导致意识障碍时,应考虑高氨血症作为鉴别诊断。