Severe chronic active hepatitis induced by UFTR containing tegafur and uracil

Abstract

A 77-year-old female patients developed severe hepatic injury after the administration of UFTR, which contains tegafur and uracil, for postoperative chemotherapy of colon cancer. Liver damage was recognized 10 months after its administration. Serum markers for viral hepatitis and various autoantibodies were negative. The wedged biopsied liver specimen revealed advanced chronic active hepatitis with periportal confluent necrosis, marked intralobular spotty necrosis, and significant proliferation of pseudo-bile ductules. Although the cessation of the drug and conservative therapies improved hepatic function, an accidental readministration of UFTR caused her severe hepatic damage again. These findings suggest that liver injury in the present case was caused by UFTR. Histological findings were unique. Although tegafur is known to worsen hepatic function when given to patients with liver cirrhosis, UFTR may also cause severe hepatic injury in those without preexisting liver disease.

Tegafur-uracil-induced rapid development of advanced hepatic fibrosis

“…Only five cases of tegafur-uracil-induced hepatic fibrosis with portal hypertension have been described in the literature[ 1 , 3 , 4 ] (Table 2 ). These patients were treated with tegafur-uracil over a long period (23-54 mo; mean 39.6 mo), and their pathological findings showed periportal fibrosis and bridging fibrosis following liver biopsy.…”

“…The development of associated advanced hepatic fibrosis is unusual. In fact, studies have shown that advanced hepatic fibrosis develops only after the long-term administration of tegafur-uracil[ 1 , 3 ]. Here, we report a case that rapidly progressed to advanced hepatic fibrosis with portal hypertension.…”

Evaluation of miR-122 to Predict High Dose Acetaminophen-Induced Liver Injury in Mice: The Combination Uses of 5-Fluorouracil

“…Therefore, the miR-122 is considered to precisely reflect the conditions of acute liver injury (ALI). 9,10) Taking this information into consideration, miR-122 is expected to be a novel biomarker for ALI. However, more evidence is required to use this biomarker in various situations such as combination use because APAP is often used along with anticancer drugs.…”