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[1例氟尿嘧啶治疗期间因高氨血症导致意识障碍的食管癌病例]

[A Case of Esophageal Cancer with Consciousness Disorder Due to Hyperammonemia during FP Treatment].

作者信息

Yamasaki Yoshimi, Ryotokuji Tairo, Matsui Toshihiro, Miura Tomiyuki, Chiba Tetsuma, Hayashi Mikiko, Yokosuka Tetsuya, Noguchi Norio, Tsunemi Akisa, Iseki Hideaki

机构信息

Dept. of Surgery, Tokyo Metropolitan Hiroo Hospital.

出版信息

Gan To Kagaku Ryoho. 2023 Apr;50(4):493-495.

Abstract

Hyperammonemia induced by 5-fluorouracil(5-FU)is known as a rare adverse event, but there are few reports of hyperammonemia occurring during FP(5-FU plus CDDP)treatment for esophageal cancer. We report a case of esophageal cancer with consciousness disorder due to hyperammonemia during FP treatment with an examination of some of the relevant literature. The patient was a man of approximately 70 years of age who was received FP treatment. He showed consciousness disorder on day 4. A blood test showed hyperammonemia(427μg/dL), which was considered to be the cause of his consciousness disorder. He was treated with branched chain amino acid infusion, lactulose and kanamycin and made a full recovery. An operation for esophageal cancer was performed after 3 months and he is currently followed up without recurrence. Hyperammonemia should be considered as a differential diagnosis of consciousness disorder during chemotherapy including 5-FU.

摘要

5-氟尿嘧啶(5-FU)诱发的高氨血症是一种罕见的不良事件,但关于食管癌氟尿嘧啶和顺铂(FP,5-FU加顺铂)治疗期间发生高氨血症的报道较少。我们报告1例食管癌患者在FP治疗期间因高氨血症出现意识障碍,并对一些相关文献进行了研究。患者为一名70岁左右的男性,接受FP治疗。第4天出现意识障碍。血液检查显示高氨血症(427μg/dL),被认为是其意识障碍的原因。给予其支链氨基酸输注、乳果糖和卡那霉素治疗后完全康复。3个月后进行了食管癌手术,目前正在接受随访,无复发。在包括5-FU在内的化疗期间,高氨血症应被视为意识障碍的鉴别诊断之一。

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