5-FU脳症の2例

Acute Encephalopathy Induced by 5-Fluorouracil: Report of Two Cases

　はじめに

　5-fluorouracil（5-FU）が1956年に開発されて以来，5-FUの長期投与に伴う副作用として白質脳症が多数報告されている^1〜3）。しかし，急性脳症に関する報告4）は僅かで，その症状や病態は明らかではない。今回，5-FUの1,000mg／m²5日間の持続静注治療を行った243症例中，5-FUが起因したと思われる急性脳症を2例経験し，その症状や検査所見の特徴，白質脳症との比較などを検討したので報告する。

Abstract Two patients developed acute encephalopathy associated with a continuous 5-fluorouracil (5-FU) infusion. The patients presented with dysarthria,retraction of the root of the tongue and disorienta-tion. Intravenous administration of steroid and glycerin produced neurologic recovery for a while, but the symptoms became worse again. Tra-cheotomy was performed for one patient and nasal air way was necessary for another patient. The pathogenesis of 5-FU neurotoxicity may be due to a Krebs cycle blockade, thiamine deficiency, or dihy-drouracil dehydrogenase deficincy. It is necessary to be aware of this complication during 5-FU infusion therapy.