5-Fluorouracil Neurotoxicity in the Absence of Dihydropyrimidine Dehydrogenase Deficiency Case Report

Area of Science:

• Oncology
• Neuroscience
• Pharmacology

Background:

• 5-fluorouracil (5-FU) is a common chemotherapy agent.
• Neurotoxicity is a rare but severe adverse effect of 5-FU.
• Dihydropyrimidine dehydrogenase (DPD) deficiency increases 5-FU toxicity risk.

Observation:

• A patient with colorectal adenocarcinoma received FOLFOX (leucovorin calcium, 5-fluorouracil, oxaliplatin).
• The patient, without DPD deficiency, experienced acute neurotoxicity.
• Neurotoxicity presented with global diffusion restriction on imaging.

Findings:

• Uridine triacetate administration was followed by resolution of neurotoxicity.
• This suggests a potential role for uridine triacetate in managing 5-FU-induced neurotoxicity.
• The patient's lack of DPD deficiency highlights other potential mechanisms for 5-FU neurotoxicity.

Implications:

• This case expands understanding of 5-FU neurotoxicity mechanisms.
• Uridine triacetate may be a therapeutic option for 5-FU neurotoxicity, even in non-DPD deficient patients.
• Further research is warranted to explore uridine triacetate's efficacy and safety in managing chemotherapy-induced neurotoxicity.