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Case Reports
. 2023 May 18;10(2):55-60.
doi: 10.22551/2023.39.1002.10241. eCollection 2023.

Recurrent cardiotoxicity in a fluoropyrimidine treated cancer patient - case report and practical recommendations

Andrada Larisa Deac  1   2 , Raluca Maria Pop  2 , Cristina Florina Crisan  3 , Claudia Cristina Burz  4 , Anca Dana Buzoianu  2
Affiliations
Case Reports

Recurrent cardiotoxicity in a fluoropyrimidine treated cancer patient - case report and practical recommendations

Andrada Larisa Deac et al. Arch Clin Cases. .

Abstract

Fluoropyrimidines remain some of the most used chemotherapeutics, despite the appearance in the therapeutic arsenal of targeted therapy and immunotherapy. Fluropyrimidines related cardiotoxicity is an undesirable adverse event and affects almost 20% of patients. The mechanisms of fluoropyrimidine toxicity are closely related to deficient allelic variants of DPYD, but considering the low penetrance and interindividual variability, not all adverse reactions are explained by their presence. In this case, we report a patient with recurrent fluoropyrimidine toxicity without a deficient allelic variant and how this case was managed by the oncologist and cardiologist, considering the need to use fluoropyrimidine in the treatment.

Keywords: DPYD; cardiotoxicity; colon cancer; fluoropyrimidines; mutation testing.

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Conflict of interest statement

The authors have no conflict of interests.

Figures

Fig. 1
Fig. 1
The first ECG during the second chemotherapy cycle.
Fig. 2
Fig. 2
The ECG during a crisis, after the treatment was resumed.
Fig. 3
Fig. 3
The persistence of ECG changes 1 hour after the onset symptoms, despite treatment with Nitroglycerine.
Fig. 4
Fig. 4
Maintenance of ECG changes 3 hours after the onset of symptoms.
See this image and copyright information in PMC

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