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Per Med ; 14(3): 197-201, 2017 05.
Article in English | MEDLINE | ID: mdl-29767581

ABSTRACT

Some articles have reported severe toxicities induced by cisplatin/5-fluorouracil regimens, nevertheless, severe and lethal liver toxicity has not been previously reported. In this article, we report the case of a 72-year-old woman, who developed fulminant hepatitis, hypoglycemia and hypotension with atrial fibrillation not responding to treatment. After ruling out all other possible causes of hepatitis, the toxicity was more likely attributed to 5-fluorouracil. Genotyping was performed and the patient was found to be a homozygote carrier of the T variant of the MTHFR gene. The patient died two days later. Several factors, including genetic factors, could explain this severe toxicity. The present case discusses the importance of personalized medicine in oncology based on pharmacogenetic analysis of polymorphisms.


Subject(s)
Cisplatin/toxicity , Fluorouracil/toxicity , Liver Failure, Acute/chemically induced , Aged , Chemical and Drug Induced Liver Injury/drug therapy , Cisplatin/adverse effects , Drug-Related Side Effects and Adverse Reactions/drug therapy , Female , Fluorouracil/adverse effects , Humans , Methylenetetrahydrofolate Reductase (NADPH2)/analysis , Methylenetetrahydrofolate Reductase (NADPH2)/blood , Methylenetetrahydrofolate Reductase (NADPH2)/genetics , Pharmacogenetics , Pharmacogenomic Testing
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