Abstract
Idiopathic hyperammonemic encephalopathy is a rare complication of chemotherapy, which has previously mainly been associated with L-asparaginase, cytarabine and 5-FU. We present a case following treatment with gemcitabine–cisplatin in a patient with cholangiocarcinoma. The etiology of chemotherapy-induced idiopathic hyperammonemic encephalopathy remains unclear and existing theories differ per chemotherapeutic agent. Physicians treating patients with gemcitabine–cisplatin should be aware of the possibility of this complication, especially because it is treatable when recognized early.
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References
Park JO, Oh D-Y, Hsu C, Chen J-S, Chen L-T, Orlando M et al (2015) Gemcitabine plus cisplatin for advanced biliary tract cancer: a systematic review. Cancer Res Treat 47:343–361. https://doi.org/10.4143/crt.2014.308
Ren XS, Harada K, Yoshikawa S, Igarashi S, Urabe T, Yamada S et al (2010) A fatal case of progressive steatohepatitis, possibly chemotherapy-associated steatohepatitis related to gemcitabine. Clin J Gastroenterol 3:191–194. https://doi.org/10.1007/s12328-010-0159-8
Stellman A, Loke MM, Mann S (2010) Acute liver failure secondary to gemcitabine. BMJ Case Rep. https://doi.org/10.1136/bcr.12.2008.1371
Kagohashi K, Funayama Y, Satoh H, Sekizawa K (2003) Fatal hepatic failure due to gemcitabine and vinorelbine. Ann Oncol 14:960. https://doi.org/10.1093/annonc/mdg239
Robinson K, Lambiase L, Li J, Monteiro C, Schiff M (2003) Fatal cholestatic liver failure associated with gemcitabine therapy. Dig Dis Sci 48:1804–1808. https://doi.org/10.1023/a:1025415616592
Coeman DC, Verbeken EK, Nackaerts KL, Demedts MG, Vansteenkiste JF (2000) A fatal case of cholestatic liver failure probably related to gemcitabine. Ann Oncol 11:1503. https://doi.org/10.1023/a:1026514527313
Willson KJ, Nott LM, Broadbridge VT, Price T (2013) Hepatic encephalopathy associated with cancer or anticancer therapy. Gastrointest Cancer Res 6:11–16
Nott L, Price TJ, Pittman K, Patterson K, Fletcher J (2007) Hyperammonemia encephalopathy: an important cause of neurological deterioration following chemotherapy. Leuk Lymphoma 48:1702–1711. https://doi.org/10.1080/10428190701509822
Chen Y-H, Chiou T-J, Hsu Y-N, Liu C-Y (2010) Idiopathic hyperammonemia after chemotherapy with vinorelbine, topotecan, and cisplatin in a patient with acute lymphocytic leukemia. Hematol Oncol Stem Cell Ther 3:199–202. https://doi.org/10.5144/1658-3876.2010.199
Ogata T, Satake H, Ogata M, Hatachi Y, Yasui H (2017) Oxaliplatin-induced hyperammonemic encephalopathy in a patient with metastatic pancreatic cancer: a case report. Case Rep Oncol 10:885–889. https://doi.org/10.1159/000481398
Lazier J, Lupichuk SM, Sosova I, Khan AA (2014) Hyperammonemic encephalopathy in an adenocarcinoma patient managed with carglumic acid. Curr Oncol 21:736–739. https://doi.org/10.3747/co.21.2076
Mini E, Nobili S, Caciagli B, Landini I, Mazzei T (2006) Cellular pharmacology of gemcitabine. Ann Oncol 17:v7-12. https://doi.org/10.1093/annonc/mdj941
Gilbert JA, Salavaggione OE, Ji Y, Pelleymounter LL, Eckloff BW, Wieben ED et al (2006) Gemcitabine pharmacogenomics: cytidine deaminase and deoxycytidylate deaminase gene resequencing and functional genomics. Clin Cancer Res 12:1794–1803. https://doi.org/10.1158/1078-0432.CCR-05-1969
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Verkerk, K., Otten, HM. & Huitema, A.D.R. Idiopathic hyperammonemic encephalopathy secondary to gemcitabine–cisplatin treatment. Cancer Chemother Pharmacol 90, 417–419 (2022). https://doi.org/10.1007/s00280-022-04476-6
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DOI: https://doi.org/10.1007/s00280-022-04476-6