Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case Report

Autor: Mark Zupancic, Pedro Farrajota Neves da Silva, Karam Kas Elyas, Signe Friesland, Thomasine Ellingsen Cederö, Marco Gerling
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Case Reports in Oncology, Vol 16, Iss 1, Pp 525-531 (2023)
Druh dokumentu: article
ISSN: 1662-6575
00053147
DOI: 10.1159/000531472
Popis: Chemotherapy-related encephalopathy is a rare but severe side effect of cancer therapy. Few reports exist on the course of encephalopathy due to 5-fluorouracil (5FU)/carboplatin treatment. Here, we report on a patient in his 70s, who received first-line palliative treatment with carboplatin followed by continuous infusion of 5FU against a metastasized cancer of the base of the tongue. During the first 5FU infusion, the patient developed a coma with sudden onset. In contrast to earlier reports of 5FU-induced encephalopathy, serum ammonium levels were near-normal, despite a slightly increased bilirubin. The electroencephalogram showed signs of general encephalopathy, for which no other probable cause than chemotherapy could be identified. Based on historical reports, the patient’s encephalopathy was likely due to 5FU treatment rather than carboplatin. While initially in a coma with a Glasgow Coma Scale score of three, the patient regained consciousness within 3 days of supportive therapy. This case highlights the potentially benign clinical course of 5FU-induced encephalopathy, characterized by fulminant clinical deterioration and quick recovery. Such a rapid deterioration in a palliative setting can pose a clinical dilemma, where invasive treatments such as intubation must be weighed against a limited prognosis, for which this case may provide guidance.
Databáze: Directory of Open Access Journals
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