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一名患有结肠直肠癌的患者发生中性粒细胞减少性小肠结肠炎:5-氟尿嘧啶和亚叶酸治疗后的异常病程——病例报告

Neutropenic enterocolitis in a patient with colorectal carcinoma: unusual course after treatment with 5-fluorouracil and leucovorin--a case report.

作者信息

Kronawitter U, Kemeny N E, Blumgart L

机构信息

Division of Solid Tumors, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.

出版信息

Cancer. 1997 Aug 15;80(4):656-60.

PMID:9264347
Abstract

BACKGROUND

Neutropenic enterocolitis is observed in approximately 25% of patients with acute leukemia, but has been reported rarely in patients with solid tumors. If treatment is not initiated promptly, the mortality is high. The incidence of this disease is rising in patients with hematologic malignancies. Increasing numbers of patients with solid tumors are subject to high dose chemotherapy regimens or new drugs known to cause severe neutropenia. Therefore, the frequency of this disease can be expected to increase.

METHODS

The authors report a patient with colorectal carcinoma who developed neutropenic enterocolitis after treatment with 5-fluorouracil and leucovorin.

RESULTS

The patient developed the typical clinical picture of abdominal pain, diarrhea, and neutropenia. The course was complicated by a recurrence of symptoms after initially successful antibiotic therapy without the patient receiving further chemotherapy.

CONCLUSIONS

This case indicates that neutropenic enterocolitis may occur in patients with colorectal carcinoma receiving 5-fluorouracil and leucovorin.

摘要

背景

中性粒细胞减少性小肠结肠炎在约25%的急性白血病患者中可见,但在实体瘤患者中鲜有报道。若不及时开始治疗,死亡率很高。血液系统恶性肿瘤患者中该疾病的发病率正在上升。越来越多的实体瘤患者接受高剂量化疗方案或已知会导致严重中性粒细胞减少的新药治疗。因此,预计该疾病的发生率会增加。

方法

作者报告了1例接受5-氟尿嘧啶和亚叶酸治疗后发生中性粒细胞减少性小肠结肠炎的结肠癌患者。

结果

该患者出现了腹痛、腹泻和中性粒细胞减少的典型临床表现。病程中出现了起初抗生素治疗成功后症状复发的情况,此时患者未接受进一步化疗。

结论

该病例表明,接受5-氟尿嘧啶和亚叶酸治疗的结肠癌患者可能发生中性粒细胞减少性小肠结肠炎。

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