A Case of Hyperammonemic Encephalopathy after Modified FOLFOX6 Regimen for Metastatic Colon Cancer

• Published in: Nippon Daicho Komonbyo Gakkai Zasshi Vol. 64; no. 7; pp. 467 - 470
• Main Authors: Shomura, Hiroki, Nakano, Shiro, Inagaki, Mitsuhiro, Yanagida, Naoyuki, Kudo, Takeaki, Orimo, Tatsuya, Oikawa, Futoshi, Yoneya, Risa
• Format: Journal Article
• Language: English; Japanese
• Published: The Japan Society of Coloproctology 2011
• ISSN: 0047-1801; 1882-9619
• DOI: 10.3862/jcoloproctology.64.467

5-Fluorouracil and leucovorin with oxaliplatin (FOLFOX) or irinotecan (FOLFIRI) therapy are commonly-used chemotherapy regimens for metastatic colorectal cancer. Hyperammonemic encephalopathy is a relatively rare adverse event of chemotherapy using 5-FU. Herein, we report a case of hyperammonemic encephalopathy after modified FOLFOX6 regimen for a patient with metastatic colon cancer. A 30-year-old female was diagnosed with appendix cancer with liver and peritoneum dissemination. She was treated with modified FOLFOX6 therapy. She showed confusion on treatment day 3 of the fifth cycle of FOLFOX therapy. Laboratory examination revealed her serum ammonia level to be 503μg/dl. We diagnosed 5-FU-induced hyperammonemia, and treated her with branched-chain amino acid solutions. Her consciousness improved during that night.