Journal of Clinical Case Reports

FOLFIRI Chemotherapy-Induced Diabetic Ketoacidosis

Abstract

Carlos Tavares Bello, Ricardo Castro Fonseca, João Sequeira Duarte and Carlos Vasconcelos

Diabetic ketoacidosis (DKA) is a frequently encountered medical emergency that usually develops in the setting of severe insulin deficiency. It may be the initial clinical presentation of newly diagnosed diabetes mellitus; however, it is usually triggered by a severe medical illness or insulin therapy omission in patients with previously diagnosed diabetes mellitus. FOLFIRI (FOLinic acid, 5-fluorouracil and IRInotecan) is a systemic chemotherapy regiment frequently employed in the management of advanced colorectal carcinoma. Besides the common and well known hematological toxicity, 5-fluorouracil based chemotherapy has been associated with new onset diabetes and worsening glycemic control in known diabetics. The authors report on a case of DKA in a previously well-controlled type 2 diabetic patient upon exposure to FOLFIRI chemotherapy.