Sunitinib-induced hyperammonemic encephalopathy in metastatic gastrointestinal stromal tumors:A case report  

作　　者：Takaoki Hayakawa Shinsuke Funakoshi Yasuo Hamamoto Kenro Hirata Takanori Kanai 

机构地区：[1]Department of Internal Medicine,Division of Gastroenterology and Hepatology,Keio University School of Medicine,Shinjuku-ku 160-8582,Tokyo,Japan [2]Division of Medical Oncology,Department of Internal Medicine,Tokyo Saiseikai Central Hospital,Minato-ku 108-0073,Tokyo,Japan [3]Keio Cancer Center,Keio University School of Medicine,Shinjuku-ku 160-8582,Tokyo,Japan [4]Department of Internal Medicine,Keio University School of Medicine,Shinjuku-ku 160-8582,Tokyo,Japan

出　　处：《World Journal of Clinical Cases》2023年第31期7629-7634,共6页世界临床病例杂志

摘　　要：BACKGROUND Sunitinib,a multi-targeted tyrosine kinase inhibitor(TKI),has been approved for the salvage treatment of gastrointestinal stromal tumors(GIST).Hyperammonemic encephalopathy is a rare but severe complication of sunitinib use.Here,we present the case of a 66-year-old male with metastatic GIST without underlying liver cirrhosis who developed sunitinib-induced hyperammonemic encephalopathy.CASE SUMMARY A 66-year-old male with metastatic GIST was admitted because of reduced consciousness.Imatinib was administered as the first-line systemic therapy.He experienced repeated episodes of peritonitis due to tumor perforation,and surgery was performed.Progressive disease was confirmed based on increased liver metastasis,and sunitinib was initiated as a salvage treatment.However,23 d after the third course of sunitinib,he presented to the emergency room with an episode of altered consciousness and behavioral changes.Based on the patient clinical history and examination findings,sunitinib-induced encephalopathy was suspected.Sunitinib was discontinued,and the patient was treated for hyperammonemia.The patient had a normal level of consciousness four days later,and the serum ammonia level gradually decreased.No further neurological symptoms were reported in subsequent follow-ups.CONCLUSION TKI-induced hyperammonemic encephalopathy is potentially life-threatening.Patients receiving TKIs experiencing adverse reactions should undergo systemic evaluation and prompt treatment.

关 键 词：Tyrosine protein kinase inhibitors Sunitinib malate Hyperammonemic encephalopathy Gastrointestinal stromal tumors Case report 

分 类 号：R735[医药卫生—肿瘤]