Abstract
A 73-year-old man underwent a Hartmannʼs operation for an advance rectal cancer and received UFT/UZEL therapy during six months. Nine months after the operation, he developed peritoneal dissemination and was performed bypass surgery. Then, he received mFOLFOX6 therapy. He brought about disturbance of consciousness on treatment day 2. On magnetic resonance imaging (MRI) study, abnormal findings were not detected in the central nervous system. On laboratory data, he was diagnosed as a hyperammonemia induced by a 5-fluorouracil (5-FU). He was treated with branched-chain amino acid solutions and continuous hemodiafiltration. The next day, symptom of encephalopathy was disappeared and level of serum ammonia returned within normal range.
When patients treated with mFOLFOX6 or FOLFIRI present with neurological disorders, the possibility of hyperammonemia induced by 5-FU should be taken into consideration.
