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Updated: Feb 10, 2026

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Published on: May 15, 2021
Lethal hepatotoxicity following 5-fluorouracil/cisplatin chemotherapy: a relevant case report
Aline Hajj1, Marwan Ghosn2, Diane Mourad1
1Laboratoire de Pharmacologie, Pharmacie clinique et Contrôle de Qualité des Médicaments, Pôle Technologie-Santé (PTS), Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon.
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.
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