Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Acute liver toxicity with ifosfamide in the treatment of sarcoma: a case report. | Cheung et al. Journal of Medical Case Reports 2011 5 180 http content 5 1 180 JOURNALOF medical case reports CASE REPORT Open Access Acute liver toxicity with ifosfamide in the treatment of sarcoma a case report Michelle CM Cheung1 Robin L Jones2 and Ian Judson3 Abstract Introduction Ifosfamide is a chemotherapy agent infrequently associated with liver toxicity. To the best of our knowledge this report is the first to describe serious liver toxicity associated with ifosfamide used in combination with doxorubicin that caused acute but fully reversible liver failure and encephalopathy. This report reviews the possible mechanisms by which ifosfamide causes this adverse effect. Case report A 61-year-old Caucasian woman who presented with an inoperable right neck mass due to synovial sarcoma was treated with standard-dose ifosfamide and doxorubicin. Within 24 hours of completing the first cycle of chemotherapy she developed significant derangements in liver function with a 250-fold increase in transaminase and associated synthetic function impairment and encephalopathy. No other causes of liver failure were identified. Both biochemical tests and encephalopathy were reversed after supportive management and treatment with N-acetylcysteine. No liver toxicity was observed with subsequent cycles of chemotherapy with doxorubicin alone. Conclusion This case highlights the possibility that chemotherapy agents can cause rare and idiosyncratic toxicities so physicians must be vigilant for drug reactions especially when patients do not respond to usual treatment. Introduction Ifosfamide is an alkylating cytotoxic agent used in the treatment of a variety of cancers including germ cell tumors sarcomas lymphoma and lung cancer. It is used alone or more frequently in combination with other drugs such as in the present case with doxorubicin. The dose-limiting toxicities of ifosfamide are myelosup-pression and urotoxicity. Effects on the liver are .
