Case Report
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 21, 2017; 23(31): 5823-5828
Published online Aug 21, 2017. doi: 10.3748/wjg.v23.i31.5823
Tegafur-uracil-induced rapid development of advanced hepatic fibrosis
Shuya Honda, Koji Sawada, Takumu Hasebe, Shunsuke Nakajima, Mikihiro Fujiya, Toshikatsu Okumura
Shuya Honda, Koji Sawada, Takumu Hasebe, Shunsuke Nakajima, Mikihiro Fujiya, Toshikatsu Okumura, Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, Asahikawa, Hokkaido 078-8510, Japan
Author contributions: Honda S, Sawada K, Hasebe T and Nakajima S treated this patient; Sawada K, Fujiya M and Okumura T wrote the paper.
Institutional review board statement: This study was approved by the Institutional Review Board of Asahikawa Medical University.
Informed consent statement: Written informed consent was obtained prior to this manuscript preparation.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Koji Sawada, MD, PhD, Division of Gastroenterology and Hematology/Oncology, Department of Medicine, Asahikawa Medical University, 2-1 Midorigaoka-higashi, Asahikawa, Hokkaido 078-8510, Japan. k-sawada@asahikawa-med.ac.jp
Telephone: +81-166-682462 Fax: +81-166-682469
Received: February 21, 2017
Peer-review started: February 22, 2017
First decision: June 5, 2017
Revised: June 22, 2017
Accepted: July 22, 2017
Article in press: July 24, 2017
Published online: August 21, 2017
Abstract

Tegafur-uracil has been reported to have only minor adverse effects and is associated with liver injury in 1.79% of Japanese patients. The development of tegafur-uracil-induced hepatic fibrosis with portal hypertension is rare. Here, we report a case of a 74-year-old woman with rapidly developing tegafur-uracil-induced hepatic fibrosis. The patient had no history of liver disease and had been treated with tegafur-uracil for 8 mo after breast cancer surgery. The patient was admitted to our hospital for abdominal distension and leg edema associated with liver dysfunction. Computed tomography imaging revealed massive ascites and splenomegaly, and a non-invasive assessment of liver fibrosis indicated advanced fibrosis. The histopathological findings revealed periportal fibrosis and bridging fibrosis with septation. The massive ascites resolved after discontinuing tegafur-uracil. These findings suggest that advanced hepatic fibrosis can develop from a relatively short-term administration of tegafur-uracil and that non-invasive assessment is useful for predicting hepatic fibrosis.

Keywords: Tegafur-uracil, Drug-induced liver injury, Hepatic fibrosis, Portal hypertension, Non-invasive assessment

Core tip: This case report presents a rapid development of hepatic fibrosis induced by tegafur-uracil and the usefulness of a non-invasive assessment of hepatic fibrosis. Tegafur-uracil is often administered in patients with various cancers; therefore, when liver dysfunction progresses in patients treated with tegafur-uracil, the development of hepatic fibrosis should be considered, even for short-term administration.