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首页> 外文期刊>Anticancer Research: International Journal of Cancer Research and Treatment >Fluorouracil-induced Hyperammonemia in a Patient with Colorectal Cancer
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Fluorouracil-induced Hyperammonemia in a Patient with Colorectal Cancer

机译：大肠癌患者氟尿嘧啶引起的高氨血症

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摘要

Fluorouracil (5-FU; Adrucil (R)) is a pyrimidine analog antineoplastic chemotherapy agent which works by interfering with DNA and RNA synthesis. It has an uncommon toxicity called hyperammonemic encephalopathy. This neurotoxicity is associated with a high-dose administration of 5-FU (2,600 mg/m(2)/week), with an incidence rate of 5.7%, and is not normally seen with the current dose of 1,200 mg/m(2) infused over 46 h. The mechanism behind this neurotoxicity is not known but is possibly due to accumulation of fluorocitrate, a byproduct of 5-FU metabolism. This byproduct inhibits the Krebs cycle, which causes impairment of the adenosine triphosphate-dependent urea cycle. By impairing this cycle, ammonia is not converted to urea, which in turn this leads to an accumulation of ammonia. The accumulated ammonia in the brain is metabolized to glutamine, which has been suggested to cause an increase in intracranial pressure and cerebral edema. This case report discusses how a 40-year-old male with colorectal cancer experienced 5FU-induced hyperammonemia and was treated for it and how reducing the dose by 50% led to resolution of this symptom from reoccurring.
机译：氟尿嘧啶（5-FU; Adrucil（R））是一种嘧啶类似物抗肿瘤化学治疗剂，其作用是干扰DNA和RNA的合成。它有一种罕见的毒性，称为高氨性脑病。这种神经毒性与5-FU大剂量给药（2,600 mg / m（2）/周）有关，发生率为5.7％，当前剂量为1,200 mg / m（2）通常不可见）注入46小时以上。这种神经毒性的机制尚不清楚，但可能是由于5-FU代谢副产物氟柠檬酸的积累。该副产物抑制了Krebs循环，这导致了依赖于三磷酸腺苷的尿素循环的损害。通过破坏该循环，氨不会转化为尿素，这反过来导致氨的积累。脑中积累的氨被代谢为谷氨酰胺，已被认为会引起颅内压升高和脑水肿。该病例报告讨论了40岁的大肠癌男性如何经历5FU诱导的高氨血症并对其进行了治疗，以及如何将剂量减少50％导致该症状不再发作。

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