Reversible leukoencephalopathy with stroke-like presentation in a patient with 5-dihydropyrimidine dehydrogenase deficiency treated with continuous 5-fluorouracil infusion

Jia Li, James J. Lee, Edward Chu, Joachim M. Baehring

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Leukoencephalopathy with stroke-like presentation (LEPS) is a rare complication of various chemotherapeutic agents, and it is associated with specific findings on diffusion-weighted MRI (DW-MRI). Herein, we report a case of LEPS in a patient treated with 5-fluorouracil (5-FU) who was found to be deficient in dihydropyrimidine dehydrogenase (DPD). • While the clinical syndrome of LEPS is well known, only limited DW-MRI data in LEPS after 5-FU exposure is presently available. The histopathological basis for these DW-MRI abnormalities may consist of vacuolation secondary to splitting of the myelin intraperiod line. • Early recognition of LEPS in 5-FU recipients is important to prevent irreversible neurologic damage from prolonged exposure. A comprehensive neuroimaging evaluation including DW-MRI is recommended to spare unnecessary and inappropriate invasive procedures or therapies.

Original languageEnglish (US)
Pages (from-to)215-217
Number of pages3
JournalClinical colorectal cancer
Volume11
Issue number3
DOIs
StatePublished - Sep 2012
Externally publishedYes

Keywords

  • 5-fluorouracil
  • ADC
  • DPD deficiency
  • DWI
  • Leukoencephalopathy

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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