Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case Report
Chemotherapy-related encephalopathy is a rare but severe side effect of cancer therapy. Few reports exist on the course of encephalopathy due to 5-fluorouracil (5FU)/carboplatin treatment. Here, we report on a patient in his 70s, who received first-line palliative treatment with carboplatin followed...
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| Format: | Article |
| Language: | English |
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Karger Publishers
2023-07-01
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| Series: | Case Reports in Oncology |
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| Online Access: | https://beta.karger.com/Article/FullText/531472 |
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| author | Mark Zupancic Pedro Farrajota Neves da Silva Karam Kas Elyas Signe Friesland Thomasine Ellingsen Cederö Marco Gerling |
| author_facet | Mark Zupancic Pedro Farrajota Neves da Silva Karam Kas Elyas Signe Friesland Thomasine Ellingsen Cederö Marco Gerling |
| author_sort | Mark Zupancic |
| collection | DOAJ |
| description | Chemotherapy-related encephalopathy is a rare but severe side effect of cancer therapy. Few reports exist on the course of encephalopathy due to 5-fluorouracil (5FU)/carboplatin treatment. Here, we report on a patient in his 70s, who received first-line palliative treatment with carboplatin followed by continuous infusion of 5FU against a metastasized cancer of the base of the tongue. During the first 5FU infusion, the patient developed a coma with sudden onset. In contrast to earlier reports of 5FU-induced encephalopathy, serum ammonium levels were near-normal, despite a slightly increased bilirubin. The electroencephalogram showed signs of general encephalopathy, for which no other probable cause than chemotherapy could be identified. Based on historical reports, the patient’s encephalopathy was likely due to 5FU treatment rather than carboplatin. While initially in a coma with a Glasgow Coma Scale score of three, the patient regained consciousness within 3 days of supportive therapy. This case highlights the potentially benign clinical course of 5FU-induced encephalopathy, characterized by fulminant clinical deterioration and quick recovery. Such a rapid deterioration in a palliative setting can pose a clinical dilemma, where invasive treatments such as intubation must be weighed against a limited prognosis, for which this case may provide guidance. |
| first_indexed | 2024-03-12T15:29:39Z |
| format | Article |
| id | doaj.art-8863857712894794835537ac2d770bc8 |
| institution | Directory Open Access Journal |
| issn | 1662-6575 |
| language | English |
| last_indexed | 2024-03-12T15:29:39Z |
| publishDate | 2023-07-01 |
| publisher | Karger Publishers |
| record_format | Article |
| series | Case Reports in Oncology |
| spelling | doaj.art-8863857712894794835537ac2d770bc82023-08-10T08:11:07ZengKarger PublishersCase Reports in Oncology1662-65752023-07-0116152553110.1159/000531472531472Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case ReportMark Zupancic0https://orcid.org/0000-0003-4013-7688Pedro Farrajota Neves da Silva1Karam Kas Elyas2Signe Friesland3Thomasine Ellingsen Cederö4Marco Gerling5https://orcid.org/0000-0002-1810-0662Medical Unit Head, Neck, Lung, and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, SwedenDepartment of Oncology-Pathology, Karolinska Institutet, Solna, SwedenMedical Unit Head, Neck, Lung, and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, SwedenMedical Unit Head, Neck, Lung, and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, SwedenMedical Unit Head, Neck, Lung, and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, SwedenMedical Unit Head, Neck, Lung, and Skin Cancer, Theme Cancer, Karolinska University Hospital, Stockholm, SwedenChemotherapy-related encephalopathy is a rare but severe side effect of cancer therapy. Few reports exist on the course of encephalopathy due to 5-fluorouracil (5FU)/carboplatin treatment. Here, we report on a patient in his 70s, who received first-line palliative treatment with carboplatin followed by continuous infusion of 5FU against a metastasized cancer of the base of the tongue. During the first 5FU infusion, the patient developed a coma with sudden onset. In contrast to earlier reports of 5FU-induced encephalopathy, serum ammonium levels were near-normal, despite a slightly increased bilirubin. The electroencephalogram showed signs of general encephalopathy, for which no other probable cause than chemotherapy could be identified. Based on historical reports, the patient’s encephalopathy was likely due to 5FU treatment rather than carboplatin. While initially in a coma with a Glasgow Coma Scale score of three, the patient regained consciousness within 3 days of supportive therapy. This case highlights the potentially benign clinical course of 5FU-induced encephalopathy, characterized by fulminant clinical deterioration and quick recovery. Such a rapid deterioration in a palliative setting can pose a clinical dilemma, where invasive treatments such as intubation must be weighed against a limited prognosis, for which this case may provide guidance.https://beta.karger.com/Article/FullText/531472fluorouracilcarboplatinencephalopathycase report |
| spellingShingle | Mark Zupancic Pedro Farrajota Neves da Silva Karam Kas Elyas Signe Friesland Thomasine Ellingsen Cederö Marco Gerling Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case Report Case Reports in Oncology fluorouracil carboplatin encephalopathy case report |
| title | Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case Report |
| title_full | Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case Report |
| title_fullStr | Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case Report |
| title_full_unstemmed | Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case Report |
| title_short | Transient Coma and Signs of Encephalopathy Related to 5-Fluorouracil and Carboplatin: A Case Report |
| title_sort | transient coma and signs of encephalopathy related to 5 fluorouracil and carboplatin a case report |
| topic | fluorouracil carboplatin encephalopathy case report |
| url | https://beta.karger.com/Article/FullText/531472 |
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