Case report on 5-fluorouracil induced cerebrovascular accident

Introduction 5-Fluorouracil is an antineoplastic agent generally used to treat various types of solid tumors. The common adverse drug reaction associated with 5-fluorouracil are myelosuppression, mucositis, diarrhea, and hand-foot syndrome. Neurological side effects such as headache, dizziness, conv...

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Bibliographic Details
Published in:Journal of oncology pharmacy practice 2021-06, Vol.27 (4), p.1016-1019
Main Authors: Karthikeyan, Kavya, Babu, Christy M, Shaji, Shintu, Ashok, Ashwin M, Madhu, CS
Format: Article
Language:English
Subjects:
5-Fluorouracil
Antihypertensives
Blood pressure
Calcium
Case reports
Cerebellum
Chemotherapy
Diarrhea
Encephalopathy
Headache
Hemorrhage
Hypertension
Irinotecan
Magnetic resonance imaging
Mucositis
Myelosuppression
Pharmacists
Pons
Rectum
Risk factors
Risk groups
Side effects
Solid tumors
Stroke
Vomiting
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Summary:Introduction 5-Fluorouracil is an antineoplastic agent generally used to treat various types of solid tumors. The common adverse drug reaction associated with 5-fluorouracil are myelosuppression, mucositis, diarrhea, and hand-foot syndrome. Neurological side effects such as headache, dizziness, convulsion, encephalopathy, and acute cerebellar syndrome are rare in nature. Case presentation We report a case of 5-fluorouracil induced cerebrovascular accident (CVA) in a patient with no risk factors for CVA before chemotherapy. A 37 years old female patient diagnosed with carcinoma rectum underwent six cycles of chemotherapy with 5- fluorouracil- calcium leucovorin- irinotecan (FOLFIRI regimen). After completing the last cycle, she developed headache, vomiting, and facial deviation along with high blood pressure (260/160 mmHg). MRI brain was done, and it revealed acute non-hemorrhagic lacunar infarct in the left half of pons. 5-fluorouracil induced CVA was suspected and was managed with dual antiplatelet, statin, and antihypertensives. Conclusion The clinicians and clinical pharmacists must be aware about the potential of 5-FU to induce rare side effects such as CVA even in low risk patients in order to avoid permanent harm to the patient
ISSN:1078-1552
1477-092X
DOI:10.1177/1078155220954900