Kishi Patrick, Price Cynthia J
University of Arizona College of Medicine-Phoenix, Arizona 550 E. Van Buren St, Phoenix, AZ, 85004, USA.
Department of Emergency Medicine, Advocate Christ Medical Center, 4440 95th St, Oak Lawn, IL, 60453, USA.
Drug Saf Case Rep. 2018 Jan 12;5(1):4. doi: 10.1007/s40800-017-0068-6.
A 67-year-old man developed a suspected adverse drug reaction during treatment with topical 5-fluorouracil (5-FU) for multiple actinic keratosis of the face, neck, and forearms. The man received topical 5-FU at a dosage of 0.5% for the actinic keratoses. After 1 week, he developed extreme lethargy, fatigue, fever, and mouth erosions. Several days later, and after discontinuation of 5-FU, painful mucositis and systemic side effects occurred, meeting criteria for hospitalization because of dehydration and a 6.8 kg weight loss. Hematology/oncology was consulted, and a possible systemic 5-FU reaction, similar to reactions to intravenous chemotherapy seen with a dihydropyrimidine dehydrogenase deficiency was suggested. The patient was not taking any concurrent medications, and he refused dihydropyrimidine dehydrogenase deficiency testing.
一名67岁男性在使用外用5-氟尿嘧啶（5-FU）治疗面部、颈部和前臂的多发性光化性角化病时出现疑似药物不良反应。该男子接受了浓度为0.5%的外用5-FU治疗光化性角化病。1周后，他出现极度嗜睡、疲劳、发热和口腔糜烂。几天后，在停用5-FU后，出现了疼痛性粘膜炎和全身副作用，因脱水和体重减轻6.8千克而符合住院标准。咨询了血液学/肿瘤学专家，提示可能发生了全身性5-FU反应，类似于二氢嘧啶脱氢酶缺乏时静脉化疗所见的反应。患者未同时服用任何其他药物，且拒绝进行二氢嘧啶脱氢酶缺乏检测。
