A Case of Pellagra Occurred during 5-fluorouracil Therapy

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  • 5-FU 投与患者に生じたペラグラの1例

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Pellagra is caused by niacin deficiency, which develops due to a wide variety of clinical conditions. Several drugs can also cause niacin deficiency by inhibiting the conversion of tryptophan to niacin. However, although 5-fluorouracil is a known causative drug, there have been few case reports. A 63-year-old man who had underwent sigmoidectomy due to sigmoid colon cancer 3 years ago relapsed, and developed metastases in the lung and para-aortic lymph nodes. Prior to his visit to our department, he had taken mFOLFOX6 plus bevacizumab therapy and FOLFIRI plus panitumumab therapy for 8 months. During these therapies, he gradually lost his appetite, often had diarrhea, developed a pigmented rash on his face, and had frequent stomatitis. At the first visit, the patient had scaly edematous erythema, pigmentation, and dermatrophia on the exposed skin of the face and neck. He was slow to respond when spoken to. We found low blood levels of nicotinic acid and tryptophan, and diagnosed him with pellagra. His symptoms ameliorated after improvement of his diet, infusion containing amino acids, and oral administration of nicotinamide. We consider the 5-fluorouracil therapy combined with poor nutritional intake to have led to the development of pellagra.Skin Research, 17: 21-24, 2018

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  • Hifu no kagaku

    Hifu no kagaku 17 (1), 21-24, 2018

    Meeting of Osaka Dermatological Association/Meeting of Keiji Dermatological Association

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