Hyperammonemia-induced impaired consciousness following mFOLFOX6 therapy in a patient with recurrent rectal cancer

Kurokawa, Tomohiro; Kanemoto, Yoshitsugu; Azuma, Yuki; Iimura, Yohei; Kuroda, Seiichiro; Yazawa, Kentaro; Tsurita, Giichiro

doi:10.5414/cp203747

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“…A deficiency of DPD can lead to the accumulation of 5-FU and an increase in ammonia [ 12 ]. Patents with FOLFOX-induced hyperammonemic encephalopathy often present with a delay of two days after infusion, and commonly present with cognitive impairment, seizures, and confusion [ 13 , 14 ]. Several factors associated with hyperammonemia have been reported, including renal failure, dehydration, sarcopenia, and infection [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

A Case of Acute Encephalopathy After the Initiation of FOLFOX Chemotherapy in a Patient With Colon Cancer

Kim¹,

Lio²,

Henderson³

et al. 2023

Cureus

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Acute encephalopathy is a change in the level of consciousness where the underlying etiology can be difficult to diagnose, and thus, difficult to treat, especially in the context of multi-organ diseases. We report a case of acute encephalopathy in a patient with end-stage renal disease (ESRD) on hemodialysis, chronic hypotension, and a recent diagnosis of colon cancer who presented shortly after initiation of FOLFOX, a chemotherapy regimen for treatment of colorectal cancer comprised of folinic acid (leucovorin), fluorouracil (5-FU), and oxaliplatin (eloxatin). We present a systematic approach to elucidate ambiguous causes of toxicmetabolic encephalopathy.

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Section: Discussionmentioning

confidence: 99%