Abstract
Irinotecan-induced gastrointestinal toxicities are common and typically present in the form of diarrhea or nausea and vomiting. However, severe hyperbilirubinemia (grade 3/4) has not been previously reported in association with this chemotherapeutic agent. We report a case of prolonged grade 4 hyperbilirubinemia after a single dose of irinotecan at 125 mg/m(2). This severe toxicity was attributed to a UGT1A1 7/7 genotype and resolved to grade 2 after 8 weeks of supportive care. This case outlines the possibility of severe hepatic toxicity with moderate doses of irinotecan in patients with a UGT1A1 7/7 genotype. Despite the severity and prolonged duration of the associated irinotecan-induced hepatic toxicity, the management of similar cases should focus on intensive supportive measures because the toxicity is likely to resolve eventually.
MeSH terms
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Aged
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal, Humanized
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Camptothecin / administration & dosage
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Camptothecin / adverse effects
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Camptothecin / analogs & derivatives*
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Cetuximab
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Colonic Neoplasms / drug therapy*
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Colonic Neoplasms / pathology
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Colonic Neoplasms / surgery
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Fluorouracil / administration & dosage
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Fluorouracil / adverse effects
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Fluorouracil / therapeutic use
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Genotype*
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Glucuronosyltransferase / genetics*
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Humans
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Hyperbilirubinemia / chemically induced*
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Hyperbilirubinemia / drug therapy
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Hyperbilirubinemia / pathology
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Irinotecan
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Leucovorin / therapeutic use
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Liver Neoplasms / drug therapy*
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Liver Neoplasms / secondary
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Liver Neoplasms / surgery
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Male
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Organoplatinum Compounds / therapeutic use
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Polymorphism, Genetic
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Humanized
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Organoplatinum Compounds
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Irinotecan
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UGT1A1 enzyme
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Glucuronosyltransferase
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Cetuximab
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Leucovorin
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Fluorouracil
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Camptothecin