5-Fluorouracil Induced Hypertriglyceridemia During the Colorectal Cancer Treatment in a Patient With Multifactorial Chylomicronemia Syndrome: A Case Report

Clin Ther. 2024 May;46(5):429-432. doi: 10.1016/j.clinthera.2024.05.001. Epub 2024 May 19.

Abstract

Purpose: The case of a 47-year-old female patient who underwent sigmoidectomy for metastatic colorectal cancer is reported. Treatment with capecitabine and 5-fluorouracil induced severe hypertriglyceridemia repeatedly.

Methods: Based on laboratory tests and clinical evaluations, treatment was suggested by specialists.

Findings: After treatment with capecitabine, the patient's triglycerides increased from 19.7 mmol/L to 42 mmol/L. It was proposed that the patient had multifactorial chylomicronemia syndrome triggered by secondary factors. Statins, fenofibrate, ezetimib, and metformin were added to the therapy. After metastases appeared, FOLFIRI (leucovorin calcium [folinic acid], 5-fluorouracil, and irinotecan hydrochloride) chemotherapy and biological treatment (cetuximab) followed and triglycerides increased to 55.3 mmol/L.

Implications: Monitoring triglyceride levels before and during therapy is suggested.

Keywords: 5-fluorouracil; Capecitabine; Hypertriglyceridemia; Metastatic colorectal cancer; Obesity; Type 2 diabetes mellitus.

Publication types

  • Case Reports

MeSH terms

  • Antimetabolites, Antineoplastic / administration & dosage
  • Antimetabolites, Antineoplastic / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Capecitabine / administration & dosage
  • Capecitabine / adverse effects
  • Colorectal Neoplasms* / drug therapy
  • Female
  • Fluorouracil* / adverse effects
  • Humans
  • Hypertriglyceridemia* / chemically induced
  • Leucovorin / administration & dosage
  • Leucovorin / adverse effects
  • Leucovorin / therapeutic use
  • Middle Aged
  • Triglycerides / blood

Substances

  • Fluorouracil
  • Capecitabine
  • Antimetabolites, Antineoplastic
  • Triglycerides
  • Leucovorin