Wagner-Altendorf Tobias A, Heldmann Marcus, Hanssen Henrike, Münte Thomas F
Department of Neurology, University Hospital Schleswig-Holstein, Lübeck, Germany.
BMJ Case Rep. 2019 Sep 18;12(9):e231248. doi: 10.1136/bcr-2019-231248.
Capecitabine is an oral fluoropyrimidine used to treat solid tumours such as colorectal and breast cancer. A rare but severe side effect is capecitabine-induced leukoencephalopathy, including bilateral lesion to the corticospinal tract. However, neurological symptoms due to capecitabine treatment are usually reported to be reversible after discontinuation of capecitabine. Here, we present the case of a patient with bilateral degeneration of the corticospinal tract and progressive spastic tetraplegia after chemotherapy with capecitabine mimicking primary lateral sclerosis. Although therapy with capecitabine was ended, symptoms substantially worsened over the following years and the patient finally died from aspiration pneumonia almost 3 years after the application of capecitabine.
卡培他滨是一种口服氟嘧啶，用于治疗实体瘤，如结直肠癌和乳腺癌。一种罕见但严重的副作用是卡培他滨诱发的白质脑病，包括双侧皮质脊髓束病变。然而，通常报道称，卡培他滨治疗引起的神经症状在停用卡培他滨后是可逆的。在此，我们报告一例患者，其在接受卡培他滨化疗后出现双侧皮质脊髓束变性和进行性痉挛性四肢瘫，酷似原发性侧索硬化症。尽管停用了卡培他滨治疗，但症状在接下来的几年里仍大幅恶化，患者最终在应用卡培他滨近3年后死于吸入性肺炎。
