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Amrani ME, Henzlef O, Debroucker T, Roullet E, Bousser MG, Amarenco P. Brain infarction following 5-fluorouracil and cisplatin therapy. Neurology 1998; 51(3): 899-901.

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Article

Simultaneous Cardiotoxicity and Neurotoxicity Associated with 5-fluorouracil Containing Chemotherapy: A Case Report and Literature Review

1Department of Medicine, SUNY-Downstate Health Science University, 450 Clarkson Avenue, Brooklyn, New York 11203, USA


American Journal of Medical Case Reports. 2020, Vol. 8 No. 3, 73-75
DOI: 10.12691/ajmcr-8-3-2
Copyright © 2020 Science and Education Publishing

Cite this paper:
Justina Ray, Abdullah Mahmood, Muhammad Dogar, Junjing Guo, Felix Nwamaghinna, Louis Salciccioli, Samy I. McFarlane. Simultaneous Cardiotoxicity and Neurotoxicity Associated with 5-fluorouracil Containing Chemotherapy: A Case Report and Literature Review. American Journal of Medical Case Reports. 2020; 8(3):73-75. doi: 10.12691/ajmcr-8-3-2.

Correspondence to: Samy  I. McFarlane, Department of Medicine, SUNY-Downstate Health Science University, 450 Clarkson Avenue, Brooklyn, New York 11203, USA. Email: Samy.mcfarlane@downstate.edu

Abstract

We present a case of simultaneous cardiotoxicity and stroke-like neurotoxicity in a patient treated with FOLFOX, a 5-Fluorouracil (5-FU)-containing chemotherapy regimen. Within hours of FOLFOX infusion, the patient began to exhibit signs and symptoms of myocardial ischemia and stroke mimic. Coronary vasoconstriction and vasospasm is a known mechanism of 5-FU-induced cardiotoxicity. 5-FU-induced neurotoxicity commonly presents as encephalopathy and is likely attributable to the accumulation of ammonia, a product of 5-FU metabolism. However, our patient presented with focal neurological signs and normal levels of ammonia. This suggests that 5-FU-induced vasospasm in the coronary arteries and cerebral vasculature is a likely cause of the simultaneous cardiac and neurological events we report here which have not been reported previously. Recognition of these toxicities as complications of 5-FU chemotherapy is crucial for the proper diagnosis and treatment of patients.

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