Antineoplastics/folinic acid
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Bacterial peritonitis (first report with irinotecan and folinic acid): case report A 20-year-old man started receiving chemotherapy with irinotecan, folinic acid [leucovorin] and fluorouracil [dosages not stated] for metastatic colorectal cancer and, after an unspecified duration, he developed severe hypertriglyceridaemia (triglyceride level 18.1 mmol/L). After heparin-induced extracorporeal LDL-cholesterol precipitation, his triglyceride level decreased to 5.3 mmol/L. At his second chemotherapy cycle, bevacizumab 5 mg/kg [frequency not stated] was added and, after his third chemotherapy cycle, he presented with clinical features of acute abdominal crisis [time to reaction onset not clearly stated]. A CT scan showed covered stomach perforation. Investigations revealed classical macroscopic appearance of fibrinous peritonitis. Microbiological examination showed the presence of pathological concentration of Escherichia coli. [Patient outcome not stated.] Author comment: "The bacterial leakage through the intestinal wall into peritoneal cavity caused peritonitis. This process probably was faciliated by immunosuppressive state and /or as in ulcerative colitis the mechanism of permanent mechanical insults, inflammation and repair of adenomatous colonic mucosa might be involved." Mihaylova Z, et al. Bacterial peritonitis without gastro-intestinal perforation in young man with metastatic colorectal cancer treated with FOLFIRI and bevacizumab. Annals of Oncology 17 (Suppl. 9): 132 abstr. 394, Sep 2006 801051629 [abstract] - Bulgaria
» Editorial comment: A search of AdisBase and Medline did not reveal any previous case reports of bacterial peritonitis associated with irinotecan and folinic acid. The WHO Adverse Drug Reactions database contained eight reports of peritonitis associated with irinotecan and six reports of peritonitis associated with folinic acid.
0114-9954/10/1127-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 11 Nov 2006 No. 1127
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