5-FUによる末梢神経障害の1例

概要

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5-fluorouracil(5-FU) is known to cause multifocal cerebral demyelination. To date, cases of peripheral neuropathy have rarely been described after the administration of 5-FU alone. We describe one patient who had peripheral neuropathy diagnosed by electrophysiologic testing and sural nerve biopsy. A 42-year-old man was diagnosed as having early gastric carcinoma (IIc). After gastrectomy, he received chemotherapy (5-FU, 2.46 mg/kg/day) from June 19, 1996 to November 5,1998. The patient complained of weakness and sensory disturbance in the lower limbs starting from October 1998. On neurologic examination, he had distal hypesthesia to touch, distal pain, and paresthesia. Cobalamin (vitamin B_<12>) was slightly decreased, but anemia was not present. Electrophysiologic studies demonstrated slightly slowed conduction velocity of the lower limbs. Needle electromyography showed fibrillation potentials and positive sharp waves in the upper and lower limb muscles. Pathologic changes in sural nerve biopsy indicated drug poisoning.
社団法人日本リハビリテーション医学会の論文
2000-01-18