5-Fluorouracil Neurotoxicity in the Absence of Dihydropyrimidine Dehydrogenase Deficiency Case Report

Rebecca Jules; Arushi Thaper; Ryan Foster; Pouya Ameli; Christopher Robinson; Michael Pizzi; Marc-Alain Babi; Carolina B Maciel; Katharina M Busl; Raju Reddy; William Roth

doi:10.1177/19418744211068913

5-Fluorouracil Neurotoxicity in the Absence of Dihydropyrimidine Dehydrogenase Deficiency Case Report

Neurohospitalist. 2022 Apr;12(2):366-370. doi: 10.1177/19418744211068913. Epub 2022 Jan 3.

Authors

Affiliations

¹ University of Florida College of Medicine, Gainesville, FL, USA.
² Department of Internal Medicine, University of Florida College of Medicine, Gainesville, FL, USA.
³ Department of Neurology, Neurocritical Care Division, University of Florida College of Medicine, Gainesville, FL, USA.
⁴ Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Florida College of Medicine, Gainesville, FL, USA.

Abstract

5 fluorouracil (5-FU)-related neurotoxicity is a rare and severe complication of 5-FU administration. Dihydropyrimidine dehydrogenase (DPD) deficiency is associated with an increased risk of serious adverse reactions due to its role in 5-FU metabolism. We report a case of acute reversible neurotoxicity with global areas of diffusion restriction in a patient with colorectal adenocarcinoma being treated with leucovorin calcium, 5-fluorouracil, and oxaliplatin (FOLFOX) without DPD deficiency following uridine triacetate administration.

Keywords: 5 fluorouracil; case report; dihydropyrimidine dehydrogenase; neurotoxicity; status epilepticus.

Publication types

Case Reports