Abstract
Some articles have reported severe toxicities induced by cisplatin/5-fluorouracil regimens, nevertheless, severe and lethal liver toxicity has not been previously reported. In this article, we report the case of a 72-year-old woman, who developed fulminant hepatitis, hypoglycemia and hypotension with atrial fibrillation not responding to treatment. After ruling out all other possible causes of hepatitis, the toxicity was more likely attributed to 5-fluorouracil. Genotyping was performed and the patient was found to be a homozygote carrier of the T variant of the MTHFR gene. The patient died two days later. Several factors, including genetic factors, could explain this severe toxicity. The present case discusses the importance of personalized medicine in oncology based on pharmacogenetic analysis of polymorphisms.
References
Aug 28, 1998·Molecular Genetics and Metabolism·I WeisbergR Rozen
Oct 28, 1998·Proceedings of the National Academy of Sciences of the United States of America·P J Bagley, J Selhub
Apr 20, 2004·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·André B P van Kuilenburg
Aug 19, 2007·PLoS Medicine·Jesse J SwenHenk-Jan Guchelaar
May 26, 2009·Annals of Oncology : Official Journal of the European Society for Medical Oncology·S AfzalH E Poulsen
Nov 4, 2010·Chemico-biological Interactions·M A Carvalho RodriguesA C Santos
Nov 3, 2011·British Journal of Cancer·F ThomasH L McLeod
Sep 27, 2012·Annals of Oncology : Official Journal of the European Society for Medical Oncology·H J SchmollA Cervantes
Oct 2, 2012·BMC Gastroenterology·Zhen WangYuan Huang
Sep 18, 2013·Diagnostic Pathology·Simona GurzuCalin Molnar
Jan 18, 2014·American Journal of Therapeutics·Yasemin BaskinIlhan Oztop
Jul 9, 2014·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Antonio Nocchi KalilCristiane Becker Neutzling
Feb 14, 2015·Drug and Chemical Toxicology·Mohammad WaseemSuhel Parvez
Jun 27, 2015·Expert Review of Anticancer Therapy·Bruno VincenziGiuseppe Tonini
Dec 31, 2015·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·Carin A T C LunenburgHans Gelderblom
Mar 19, 2016·Basic & Clinical Pharmacology & Toxicology·Slawomir MandziukJaroslaw Dudka
May 18, 2016·Pharmacogenomics·Carin Atc LunenburgJesse J Swen
Jul 7, 2016·Annals of Oncology : Official Journal of the European Society for Medical Oncology·E Van CutsemD Arnold
Sep 3, 2016·Cancer Treatment Reviews·Didier MeulendijksJan H M Schellens
Sep 25, 2016·Annals of Oncology : Official Journal of the European Society for Medical Oncology·F LordickUNKNOWN ESMO Guidelines Committee
Oct 1, 2016·Annals of Oncology : Official Journal of the European Society for Medical Oncology·R DanesiA B P van Kuilenburg
Oct 5, 2016·Annals of Oncology : Official Journal of the European Society for Medical Oncology·M J Deenen, D Meulendijks
Jan 1, 2017·Annals of Oncology : Official Journal of the European Society for Medical Oncology·R DanesiA B P van Kuilenburg
Jan 1, 2017·Annals of Oncology : Official Journal of the European Society for Medical Oncology·M J Deenen, D Meulendijks