[Drug-induced liver injury associated with uracil/tegafur + folinate therapy]

We report a case of drug-induced liver injury associated with uracil/tegafur(UFT) + folinate (Uzel) therapy. A 73-year-old woman had undergone right hemicolectomy with ascending colon cancer in April 2008. Postoperative diagnosis was tub2, pSS, pN0, fStage II. We administered UFT + Uzel therapy(UFT 500 mg/day, Uzel 75 mg/day)as adjuvant chemotherapy after operation for 6 weeks. Two weeks after the first drug administration, she visited our hospital complaining of anorexia and general malaise. Laboratory data showed elevation of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP). She was admitted to the hospital with a diagnosis of grade 3 liver dysfunction. We supposed the cause of this liver dysfunction to be a drug-induced liver injury associated with UFT + Uzel, and administered drugs to the patient for liver protection. With time, the symptoms and elevation of AST, ALT and ALP recovered to the normal level. This case was diagnosed as drug-induced allergic liver injury by UFT, because the result of the drug lymphocyte stimulate test (DLST) was positive.