A deficiência de dihidropirimidina desidrogenase (DPD) é uma condição na qual o corpo não consegue quebrar os nucleotídeos timina e uracila. A deficiência de DPD pode ter uma ampla variedade de gravidade; alguns indivíduos podem ter vários problemas neurológicos, enquanto outros não apresentam sinais e sintomas. Os sinais e sintomas em indivíduos gravemente afetados começam na infância e podem incluir convulsões, deficiência intelectual, microcefalia, aumento do tônus muscular (hipertonia), atraso nas habilidades motoras e comportamento autista. Todos os indivíduos com a doença, independentemente da presença ou gravidade dos sintomas, correm o risco de reações tóxicas graves a medicamentos chamados fluoropirimidinas, usados para tratar o câncer. Indivíduos sem sintomas podem ser diagnosticados apenas por exames laboratoriais ou após exposição a fluoropirimidinas. A deficiência de DPD é causada por mutações no gene DPYD e é herdada de forma autossômica recessiva.
Introdução
O que você precisa saber de cara
A deficiência de dihidropirimidina desidrogenase (DPD) é uma condição na qual o corpo não consegue quebrar os nucleotídeos timina e uracila. A deficiência de DPD pode ter uma ampla variedade de gravidade; alguns indivíduos podem ter vários problemas neurológicos, enquanto outros não apresentam sinais e sintomas. Os sinais e sintomas em indivíduos gravemente afetados começam na infância e podem incluir convulsões, deficiência intelectual, microcefalia, aumento do tônus muscular (hipertonia), atraso nas habilidades motoras e comportamento autista. Todos os indivíduos com a doença, independentemente da presença ou gravidade dos sintomas, correm o risco de reações tóxicas graves a medicamentos chamados fluoropirimidinas, usados para tratar o câncer. Indivíduos sem sintomas podem ser diagnosticados apenas por exames laboratoriais ou após exposição a fluoropirimidinas. A deficiência de DPD é causada por mutações no gene DPYD e é herdada de forma autossômica recessiva.
Escala de raridade
<1/50kMuito rara
1/20kRara
1/10kPouco freq.
1/5kIncomum
1/2k
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Sinais e sintomas
O que aparece no corpo e com que frequência cada sintoma acontece
Partes do corpo afetadas
+ 32 sintomas em outras categorias
Características mais comuns
Os sintomas variam de pessoa para pessoa. Abaixo estão as 75 características clínicas mais associadas, ordenadas por frequência.
Linha do tempo da pesquisa
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Genética e causas
O que está alterado no DNA e como passa nas famílias
Genes associados
1 gene identificado com associação a esta condição. Padrão de herança: Autosomal recessive.
Involved in pyrimidine base degradation (PubMed:1512248). Catalyzes the reduction of uracil and thymine (PubMed:1512248). Also involved the degradation of the chemotherapeutic drug 5-fluorouracil (PubMed:1512248)
Cytoplasm
Dihydropyrimidine dehydrogenase deficiency
A metabolic disorder with large phenotypic variability, ranging from no symptoms to a convulsive disorder with motor and intellectual disability. It is characterized by persistent urinary excretion of excessive amounts of uracil, thymine and 5-hydroxymethyluracil. Patients suffering from this disease show a severe reaction to the anticancer drug 5-fluorouracil.
Variantes genéticas (ClinVar)
227 variantes patogênicas registradas no ClinVar.
Classificação de variantes (ClinVar)
Distribuição de 287 variantes classificadas pelo ClinVar.
Diagnóstico
Os sinais que médicos procuram e os exames que confirmam
Tratamento e manejo
Remédios, cuidados de apoio e o que precisa acompanhar
Onde tratar no SUS
Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)
🇧🇷 Atendimento SUS — Deficiência de diidropirimidina desidrogenase
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Publicações mais relevantes
5-Fluorouracil-induced acute leukoencephalopathy in the absence of dihydropyrimidine dehydrogenase deficiency: A case report.
Introduction5-Fluorouracil (5-FU) is a chemotherapeutic agent used in various malignancies. 5-FU-induced leukoencephalopathy is a rare but reversible neurotoxic effect occurring within days of administration. Symptoms include confusion, agitation, and cognitive disturbances, with severe cases potentially causing coma. Diagnosis is supported by magnetic resonance imaging (MRI) showing characteristic brain changes. Treatment involves discontinuing 5-FU and initiating supportive care. Most patients recover within one week, but relapse may occur with repeated exposure, making early recognition critical.Case reportA 42-year-old male with recurrent Stage IV gastric adenocarcinoma and chronic kidney disease developed progressive 5-FU-related leukoencephalopathy after repeated exposure. MRI findings and symptoms of confusion, disorientation, and memory deficits were consistent with 5-FU leukoencephalopathy. Initial work-up was inconclusive, therefore, treatment was continued. Neurologic symptoms worsened after further cycles, leading to chemotherapy discontinuation and surgical resection. Disease recurrence led to reinitiation of modified 5-FU therapy, triggering acute neurotoxicity confirmed by MRI.Management and outcomeThe patient was managed by discontinuing 5-FU, beginning high-dose intravenous thiamine and methylprednisolone, and providing supportive care. Neurologic symptoms including confusion, facial diplegia, and unsteady gait gradually resolved. By Day 9, he returned to baseline mental status without deficits.DiscussionEarly recognition and intervention in 5-FU-induced leukoencephalopathy is crucial, especially in patients with renal dysfunction or repeated exposures. Dihydropyrimidine dehydrogenase (DPD) deficiency has not been directly implicated in this condition. Metabolic disruption and thiamine depletion contribute to pathogenesis. Prompt 5-FU discontinuation and initiation of supportive care can hasten recovery. Clinical vigilance is imperative in patients with known risk factors.
Functional studies of human variants in C. elegans link iron metabolism to DPD deficiency and 5-FU sensitivity.
Dihydropyrimidine dehydrogenase (DPD), encoded by DPYD, is a key enzyme in pyrimidine catabolism, and its deficiency leads to severe toxicity in patients treated with 5-fluorouracil (5-FU). While pathogenic DPYD variants account for many cases of DPD deficiency, they do not fully explain all instances of 5-FU sensitivity, suggesting additional genetic factors are involved. Recent studies have implicated variants in CIAO1, a gene encoding a subunit of the cytosolic iron-sulfur (Fe-S) cluster assembly targeting complex, in reducing DPD stability and function. In this study, we established a C. elegans model to assess DPD deficiency and 5-FU sensitivity. Using a dpyd-1 knockout and CRISPR-generated ciao-1 variants that mirror patient-derived variants (p.Trp184Cys, p.His193Tyr, and p.Arg65Trp), we provide the first in vivo evidence that pathogenic variants in CIA complex components can lead to DPD deficiency and, consequently, heightened 5-FU toxicity. Our findings highlight the critical role of CIAO1 in DPD function and 5-FU tolerance, expanding the genetic landscape of DPD deficiency and offering a robust platform for functional evaluation of pathogenic variants.
Clinical Implications of a Large-Scale Voluntary Preemptive DPYD Testing Program for Patients Planned for a Systemic Fluoropyrimidine: Preliminary Results.
To assess the impact and outcomes of a novel program for routine preemptive DPYD testing in fluoropyrimidine (FP)-naïve patients. This single-center, retrospective cohort study included adult patients who either received a systemic FP or had a DPYD test result between July 1, 2022, and June 30, 2023. Patients were categorized into preemptive or standard cohorts on the basis of the timing of their DPYD test relative to their initial FP dose. Primary outcomes measured were 90-day all-cause mortality, and FP-related hospitalizations and emergency department (ED) visits after the first FP dose. Secondary outcomes included the incidence of empiric dose reductions, FP avoidance, and dose escalation tolerability among patients with dihydropyrimidine dehydrogenase (DPD) deficiency. Among 1,281 patients, 90-day all-cause mortality was 5.78% in the preemptive cohort versus 8.23% in the standard cohort (adjusted hazard ratio [HR], 0.69 [95% CI, 0.43 to 1.10]; P = .12), with a notable overrepresentation of patients treated with curative intent in the preemptive group (53.0% v 39.4%, P < .0001). Deaths attributed to DPD deficiency were one (0.18%) in the preemptive cohort and four (0.72%) in the standard cohort (not statistically significant with limited power). Hospitalizations and ED visits related to FP toxicity were paradoxically higher in the preemptive cohort (13.99% v 8.69%, adjusted HR, 1.67 [95% CI, 1.15 to 2.43]; P = .007). Among patients with DPD deficiency in the preemptive cohort, 84.6% received an empiric FP dose reduction, and dose escalation was attempted in 52.2% of these cases. Preemptive DPYD testing did not significantly reduce treatment-related mortality, although a numerical decrease suggests potential benefits that may be substantiated with greater statistical power. Nearly half of the patients managed with a dose reduction did not undergo dose escalation.
A Lack of Complete Linkage Disequilibrium Between c.1236G>A and c.1129-5923C>G HapB3 Variants of DPYD: A Call to Revise European Pharmacogenetic Guidelines.
Fluoropyrimidine derivatives can cause severe toxicity in patients with DPD deficiency. Regulatory agencies, such as the European Medicines Agency (EMA), recommend pre-emptive genotyping of the HapB3 haplotype, along with other variants. Historically, the two main HapB3 variants, the benign c.1236G>A and the pathogenic c.1129-5923C>G, have been assumed to be in complete linkage disequilibrium. Recent findings contradict this assumption, questioning the reliability of the HapB3 analysis through c.1236G>A, which could directly impact patient safety. The aim of this study is to assess the linkage disequilibrium between the c.1236G>A and c.1129-5923C>G variants, with the ultimate goal of revising genotyping guidelines. A total of 46 patients already heterozygous for the c.1236G>A variant have been carefully reviewed for the c.1129-5923C>G variant. From the 46 patients analyzed, 45 maintain complete linkage disequilibrium between both variants. However, there is one patient where this linkage disequilibrium is not complete, being heterozygous for c.1236G>A and homozygous for c.1129-5923C>G. These findings challenge the validity of c.1236G>A as a surrogate marker for pathogenic variant c.1129-5923C>G. This article highlights the need for a review of the recommendations of the EMA and suggests laboratories to analyze both variants, or at least the pathogenic one, to ensure accurate therapeutic decisions.
Suspected capecitabine-induced fatal toxicity in the context of a new DPYD variant.
We present the case of a male in his early 70s who died after receiving adjuvant chemotherapy, probably due to an undiagnosed dihydropyrimidine dehydrogenase (DPYD) deficiency. Despite normal results from standard DPYD genotyping prior to treatment, he developed severe gastrointestinal toxicity that progressed to bowel ischaemia and ultimately death. This case underscores the potential limitations of current genotyping approaches, which may not detect rare or functionally significant DPYD variants. It also highlights the need for a cautious and comprehensive approach to fluoropyrimidine therapy, especially in patients who develop unexpected toxicity, while recognising that other contributing factors may be involved.
Publicações recentes
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Results of a phase II trial of short-course radiation and TASOX [trifluridine/tipiracil (TAS-102) plus oxaliplatin] chemotherapy in operable rectal cancer.
5-Fluorouracil-induced acute leukoencephalopathy in the absence of dihydropyrimidine dehydrogenase deficiency: A case report.
Clinical Implications of Dihydropyrimidine Dehydrogenase Deficiency in GI and Hepatopancreaticobiliary Cancers Treated With Fluoropyrimidines: A Prospective Observational Study.
Prevalence of uncommon side effects of 5-fluorouracil and capecitabine in Saudi patients with cancer: A cross-sectional observational study.
📚 EuropePMC136 artigos no totalmostrando 180
Results of a phase II trial of short-course radiation and TASOX [trifluridine/tipiracil (TAS-102) plus oxaliplatin] chemotherapy in operable rectal cancer.
ESMO gastrointestinal oncology5-Fluorouracil-induced acute leukoencephalopathy in the absence of dihydropyrimidine dehydrogenase deficiency: A case report.
Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy PractitionersDihydropyrimidine dehydrogenase testing: capturing what standard genotyping misses with next-generation sequencing.
PharmacogenomicsClinical Implications of Dihydropyrimidine Dehydrogenase Deficiency in GI and Hepatopancreaticobiliary Cancers Treated With Fluoropyrimidines: A Prospective Observational Study.
JCO global oncologyPrevalence of uncommon side effects of 5-fluorouracil and capecitabine in Saudi patients with cancer: A cross-sectional observational study.
MedicineSevere fluoropyrimidine toxicity in a patient with rectal adenocarcinoma with DPYD c.2846A>T heterozygous mutation: A case report.
Oncology lettersFunctional studies of human variants in C. elegans link iron metabolism to DPD deficiency and 5-FU sensitivity.
GeneticsA Lack of Complete Linkage Disequilibrium Between c.1236G>A and c.1129-5923C>G HapB3 Variants of DPYD: A Call to Revise European Pharmacogenetic Guidelines.
International journal of molecular sciencesPhenotyping and genotyping for the dihydropyrimidine dehydrogenase test in Italy: a precise diagnostic strategy to detect rare variants and improve drug administration.
Clinical biochemistryClinical implementation and outcome evaluation of dihydropyrimidine dehydrogenase (DPYD) pharmacogenomic testing for fluoropyrimidine dosing in a Canadian Provincial Healthcare center.
Clinical biochemistrySuspected capecitabine-induced fatal toxicity in the context of a new DPYD variant.
BMJ case reportsA thymine-challenge test to prospectively evaluate dihydropyrimidine dehydrogenase activity for risk of severe 5-fluorouracil-induced gastrointestinal toxicity.
Cancer chemotherapy and pharmacologyReducing Fluorouracil Doses in Patients With Partial Dihydropyrimidine Dehydrogenase Deficiency Is a Treatment Safety Strategy, Not a Panacea of Precision Dosing.
JCO precision oncologyDPD Ultra-Rapid Metabolizer Status and Efficacy of 5-Fluorouracil Treatment: A Real-World Study.
Fundamental & clinical pharmacologyOncology Specialists' Perceptions and Insights Into Dihydropyrimidine Dehydrogenase Testing in Palestine.
Cancer reports (Hoboken, N.J.)Clinical Implications of a Large-Scale Voluntary Preemptive DPYD Testing Program for Patients Planned for a Systemic Fluoropyrimidine: Preliminary Results.
JCO oncology practiceApplication of dihydropyrimidine dehydrogenase deficiency testing for the prevention of fluoropyrimidine toxicity: a real-world experience in a Southern Italy cancer center.
Journal of chemotherapy (Florence, Italy)Securing Fluoropyrimidine-based chemotherapy: comparison of three methods of screening for dihydropyrimidine dehydrogenase deficiency.
European review for medical and pharmacological sciencesA Guide for Implementing DPYD Genotyping for Systemic Fluoropyrimidines into Clinical Practice.
Clinical pharmacology and therapeuticsDihydropyrimidine Dehydrogenase Deficiency (DPYD) Genotyping-Guided Fluoropyrimidine-Based Adjuvant Chemotherapy for Breast Cancer. A Cost-Effectiveness Analysis.
Clinical drug investigationDihydropyrimidine enzyme activity and its effect on chemotherapy toxicity: importance of genetic testing.
Cancer chemotherapy and pharmacologyDPYD genotype should be extended to rare variants: report on two cases of phenotype / genotype discrepancy.
Cancer chemotherapy and pharmacologyPlasma clearance of 5-fluorouracil is more influenced by variations in glomerular filtration rate than by uracil concentration.
Cancer chemotherapy and pharmacologyGive Patients the Choice to Test for DPD Deficiency Before Fluoropyrimidine Chemotherapy.
JCO oncology practiceJuvenile Parkinsonism Associated With Dihydropyrimidinase Deficiency.
PediatricsReview of the fluoropyrimidine antidote uridine triacetate.
British journal of clinical pharmacologyFDA Approval Summary: Capecitabine Labeling Update under Project Renewal.
Clinical cancer research : an official journal of the American Association for Cancer ResearchPharmacogenetics of DPYD and treatment-related mortality on fluoropyrimidine chemotherapy for cancer patients: a meta-analysis and trial sequential analysis.
BMC cancerManagement of patients with reduced dihydropyrimidine dehydrogenase activity receiving combined 5-fluoruracil-/capecitabine-based chemoradiotherapy.
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]Partial protein binding of uracil and thymine affects accurate dihydropyrimidine dehydrogenase (DPD) phenotyping.
Journal of pharmaceutical and biomedical analysisIs uracil enough for effective pre-emptive DPD testing?
Clinical chemistry and laboratory medicineStrategies for DPYD testing prior to fluoropyrimidine chemotherapy in the US.
Supportive care in cancer : official journal of the Multinational Association of Supportive Care in CancerRapid determination of uracil in biological fluids at mercury thin film electrode for early detection of potential 5-fluorouracil toxicity due to dihydropyrimidine dehydrogenase deficiency.
Biosensors & bioelectronicsDihydropyrimidinase deficiency with atrioventricular septal defect: a case report.
Journal of pediatric endocrinology & metabolism : JPEMCan we identify patients carrying targeted deleterious DPYD variants with plasma uracil and dihydrouracil? A GPCO-RNPGx retrospective analysis.
Clinical chemistry and laboratory medicineA fatal case of 5-FU toxicity despite dose adjustment in a patient with a partial DPD deficiency receiving the FLOT regimen.
European journal of cancer (Oxford, England : 1990)Lethal Capecitabine Toxicity in Patients With Complete Dihydropyrimidine Dehydrogenase Deficiency Due to Ultra-Rare DPYD Variants.
JCO precision oncologyA novel large intragenic DPYD deletion causing dihydropyrimidine dehydrogenase deficiency: a case report.
BMC medical genomicsComplete DPYD genotyping combined with dihydropyrimidine dehydrogenase phenotyping to prevent fluoropyrimidine toxicity: A retrospective study.
Cancer medicineDihydropyrimidine dehydrogenase gene variants for predicting grade 4-5 fluoropyrimidine-induced toxicity: FUSAFE individual patient data meta-analysis.
British journal of cancerImpact of hemolysis on uracilemia in the context of dihydropyrimidine dehydrogenase deficiency testing.
Clinical chemistry and laboratory medicine5-Fluorouracil Neurotoxicity in a Patient With Normal Dihydropyrimidine Dehydrogenase Activity.
CureusPharmacogenetic Variants Can Influence Optical Medication Use.
Endocrine, metabolic & immune disorders drug targetsRisk of Toxicity From Topical 5-Fluorouracil Treatment in Patients Carrying DPYD Variant Alleles.
Clinical pharmacology and therapeuticsPatient and healthcare professional acceptability of pharmacogenetic screening for DPYD and UGT1A1: A cross sectional survey.
Clinical and translational scienceThe Incidence of Hematological Toxicities in Colorectal Cancer Patients Treated With Fluoropyrimidine-Based Regimens at Princess Noorah Oncology Center.
CureusDPD deficiency in an Irish oncology centre: Prevalence and clinical implications.
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ESMO openA Rare Genetic-Metabolic Cause of Epileptic Spasms: Dihydropyrimidine Dehydrogenase Deficiency.
Indian journal of pediatricsScreening for dihydropyrimidine dehydrogenase deficiency by measuring uracilemia in chronic kidney disease patients is associated with a high rate of false positives.
Clinica chimica acta; international journal of clinical chemistryImplementation of dihydropyrimidine dehydrogenase deficiency testing in Europe.
ESMO openPhenotype/Genotype Discrepancy of DPD Deficiency Screening in a Patient With Severe Capecitabine Toxicity: A Case Report.
JCO precision oncologyDiscrepancies between dihydropyrimidine dehydrogenase phenotyping and genotyping: What are the explanatory factors?
British journal of clinical pharmacologyPrecision Management of a Patient With Dihydropyrimidine Dehydrogenase Deficiency and Liver-Predominant Metastatic Rectal Cancer Using Hepatic Arterial Floxuridine.
JCO precision oncologyAwareness and attitudes of oncology specialists toward dihydropyrimidine dehydrogenase testing in Saudi Arabia.
Cancer reports (Hoboken, N.J.)Implementation and clinical benefit of DPYD genotyping in a Danish cancer population.
ESMO openDPYD Exon 4 Deletion Associated with Fluoropyrimidine Toxicity and Importance of Copy Number Variation.
Current oncology (Toronto, Ont.)Renal impairment and abnormal liver function tests in pre-therapeutic phenotype-based DPD deficiency screening using uracilemia: a comprehensive population-based study in 1138 patients.
Therapeutic advances in medical oncologyDPYD genotyping and predicting fluoropyrimidine toxicity: where do we stand?
PharmacogenomicsCurrent diagnostic and clinical issues of screening for dihydropyrimidine dehydrogenase deficiency.
European journal of cancer (Oxford, England : 1990)Predicting Dihydropyrimidine Dehydrogenase Deficiency and Related 5-Fluorouracil Toxicity: Opportunities and Challenges of DPYD Exon Sequencing and the Role of Phenotyping Assays.
International journal of molecular sciencesPlasma Uracil as a DPD Phenotyping Test: Pre-Analytical Handling Matters!
Clinical pharmacology and therapeuticsImpact of Guidelines Regarding Dihydropyrimidine Dehydrogenase (DPD) Deficiency Screening Using Uracil-Based Phenotyping on the Reduction of Severe Side Effect of 5-Fluorouracil-Based Chemotherapy: A Propension Score Analysis.
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Methods in molecular biology (Clifton, N.J.)Quantitative impact of pre-analytical process on plasma uracil when testing for dihydropyrimidine dehydrogenase deficiency.
British journal of clinical pharmacologyIntroducing a simple and cost-effective RT-PCR protocol for detection of DPYD*2A polymorphism: the first study in Kurdish population.
Cancer chemotherapy and pharmacologyRenal impairment and DPD testing: Watch out for false-positive results!
British journal of clinical pharmacologyTesting for Dihydropyrimidine Dehydrogenase Deficiency to Individualize 5-Fluorouracil Therapy.
CancersDetermination of plasma uracil as a screening for dihydropyrimidine dehydrogenase deficiency: clinical application in oncological treatments.
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Clinical biochemistryCost-effectiveness of DPYD Genotyping Prior to Fluoropyrimidine-based Adjuvant Chemotherapy for Colon Cancer.
Clinical colorectal cancerDihydropyrimidine Dehydrogenase Deficiency and Implementation of Upfront DPYD Genotyping.
Clinical pharmacology and therapeuticsCancer genomic profiling identified dihydropyrimidine dehydrogenase deficiency in bladder cancer promotes sensitivity to gemcitabine.
Scientific reportsClinical considerations for DPD deficiency testing in advanced cancer patients: tumor lysis syndrome should be considered as a major interference.
Annals of oncology : official journal of the European Society for Medical Oncology5-Fluorouracil Neurotoxicity in the Absence of Dihydropyrimidine Dehydrogenase Deficiency Case Report.
The NeurohospitalistDihydropyrimidine Dehydrogenase Phenotyping Using Pretreatment Uracil: A Note of Caution Based on a Large Prospective Clinical Study.
Clinical pharmacology and therapeuticsSurvey of US Medical Oncologists' Practices and Beliefs Regarding DPYD Testing Before Fluoropyrimidine Chemotherapy.
JCO oncology practiceSevere Gastrointestinal Disorder Due to Capecitabine Associated with Dihydropyrimidine Dehydrogenase Deficiency: A Case Report and Literature Review.
Internal medicine (Tokyo, Japan)[A Case of Colon Cancer with Suspected DPD Deficiency Causing Severe Adverse Effects following Adjuvant Chemotherapy with Capecitabine].
Gan to kagaku ryoho. Cancer & chemotherapyTreating patients with dihydropyrimidine dehydrogenase (DPD) deficiency with fluoropyrimidine chemotherapy since the onset of routine prospective testing-The experience of a large oncology center in the United Kingdom.
Seminars in oncologyEndogenous metabolic markers for predicting the activity of dihydropyrimidine dehydrogenase.
Clinical and translational scienceTesting for dihydropyrimidine dehydrogenase deficiency in New Zealand to improve the safe use of 5-fluorouracil and capecitabine in cancer patients.
The New Zealand medical journalStandard-Dose Trifluridine/Tipiracil as Safe Treatment Alternative in Metastatic Colorectal Cancer Patients With DPD Deficiency.
Clinical colorectal cancerSevere 5-Fluorouracil-Associated Gastrointestinal Toxicity Unexplained by Dihydropyrimidine Dehydrogenase Deficiency and Renal Impairment: Should We Be Investigating Other Elimination Pathways to Assess the Risk of 5-Fluorouracil Toxicity?
European journal of drug metabolism and pharmacokineticsPretherapeutic screening for Dihydropyrimidine deshydrogenase deficiency in measuring uracilemia in dialysis patients leads to a high rate of falsely positive results.
Cancer chemotherapy and pharmacologyPathogenic DPYD Variants and Treatment-Related Mortality in Patients Receiving Fluoropyrimidine Chemotherapy: A Systematic Review and Meta-Analysis.
The oncologistDPYD Exome, mRNA Expression and Uracil Levels in Early Severe Toxicity to Fluoropyrimidines: An Extreme Phenotype Approach.
Journal of personalized medicineA Facile Method for the Quantification of Urinary Uracil Concentration by a Uracil-Specific Fluorescence Derivatization Reaction.
Chemical & pharmaceutical bulletinA case of necrotic enteritis during neoadjuvant chemotherapy with gemcitabine and S-1 for resectable pancreatic ductal adenocarcinoma.
Clinical journal of gastroenterologyHow I treat stage II colon cancer patients.
ESMO openIssues and limitations of available biomarkers for fluoropyrimidine-based chemotherapy toxicity, a narrative review of the literature.
ESMO openLeukoencephalopathy with transient splenial lesions related to 5-fluorouracil or capecitabine.
European journal of neurologyDetecting DPD deficiency: when perfect is the enemy of good.
Cancer chemotherapy and pharmacologyArtificial increase of uracilemia during fluoropyrimidine treatment can lead to DPD deficiency misinterpretation.
Annals of oncology : official journal of the European Society for Medical OncologyImpact of pretreatment dihydropyrimidine dehydrogenase genotype-guided fluoropyrimidine dosing on chemotherapy associated adverse events.
Clinical and translational scienceAutism: Screening of inborn errors of metabolism and unexpected results.
Autism research : official journal of the International Society for Autism ResearchSevere toxicity of capecitabine in a patient with DPD deficiency after a safe FEC-100 experience: why we should test DPD deficiency in all patients before high-dose fluoropyrimidines.
Cancer chemotherapy and pharmacology[Phenotype- or genotype test for dihydropyrimidin dehydrogenase deficiency before treatment with a fluoropyrimidine].
Ugeskrift for laegerPreemptive screening of DPYD as part of clinical practice: high prevalence of a novel exon 4 deletion in the Finnish population.
Cancer chemotherapy and pharmacologyDihydropyrimidine Dehydrogenase Deficiency: To Screen or Not to Screen?
Journal of the advanced practitioner in oncologyJoint Belgian recommendation on screening for DPD-deficiency in patients treated with 5-FU, capecitabine (and tegafur).
Acta clinica BelgicaDihydropyrimidine dehydrogenase deficiency in patients with severe toxicity after 5-fluorouracil: a retrospective single-center study.
Annals of gastroenterologyA Japanese Patient with Gastric Cancer and Dihydropyrimidine Dehydrogenase Deficiency Presenting with DPYD Variants.
Acta medica OkayamaReal-world Safety and Efficacy of Raltitrexed in Patients With Metastatic Colorectal Cancer.
Clinical colorectal cancerWhen helping the minority of patients may hurt the majority: The case for DPD phenotyping and 5-fluorouracil therapeutic drug monitoring.
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the LiverDual deficiency of DPD and UGT1A1 in a case of colon cancer.
PharmacogenomicsIndividualized Dosing of Fluoropyrimidine-Based Chemotherapy to Prevent Severe Fluoropyrimidine-Related Toxicity: What Are the Options?
Clinical pharmacology and therapeuticsPopulation-scale predictions of DPD and TPMT phenotypes using a quantitative pharmacogene-specific ensemble classifier.
British journal of cancer5-Fluorouracil Rechallenge After Cardiotoxicity.
The American journal of case reportsHyperammonemic encephalopathy during XELOX regimen. Is it capecitabine or oxaliplatin responsible?
Anti-cancer drugsExposure-response analysis of Raltitrexed assessing liver toxicity.
British journal of clinical pharmacologyA comprehensive population-based study comparing the phenotype and genotype in a pretherapeutic screen of dihydropyrimidine dehydrogenase deficiency.
British journal of cancerNew DPYD variants causing DPD deficiency in patients treated with fluoropyrimidine.
Cancer chemotherapy and pharmacologyPosterior reversible encephalopathy syndrome: A rare neurotoxicity after capecitabine.
Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy PractitionersAutomatic quantification of uracil and dihydrouracil in plasma.
Journal of chromatography. B, Analytical technologies in the biomedical and life sciences5-Fluorouracil-induced hyperammonaemic encephalopathy: A French national survey.
European journal of cancer (Oxford, England : 1990)A Simple and Rapid UPLC-UV Method for Detecting DPD Deficiency in Patients With Cancer.
Clinical and translational scienceAn Application of Machine Learning in Pharmacovigilance: Estimating Likely Patient Genotype From Phenotypical Manifestations of Fluoropyrimidine Toxicity.
Clinical pharmacology and therapeuticsDelaying Centrifugation and Freezing by Adding a Dihydropyrimidine Dehydrogenase Inhibitor Such as Gimeracil to Blood Sample Is Not a Valid Option to Simplify the Preanalytic Step for the Screening of Dihydropyrimidine Dehydrogenase Deficiency Using Uracilemia.
Therapeutic drug monitoringPrevalence of the DPYD variant (Y186C) in Brazilian individuals of African ancestry.
Cancer chemotherapy and pharmacologyLethal toxicities after capecitabine intake in a previously 5-FU-treated patient: why dose matters with dihydropryimidine dehydrogenase deficiency.
PharmacogenomicsSafety Report of TAS-102 in a Patient With Reduced DPD Activity.
Clinical colorectal cancerFluoropyrimidine-induced toxicity and DPD deficiency.. A case report of early onset, lethal capecitabine-induced toxicity and mini review of the literature. Uridine triacetate: Efficacy and safety as an antidote. Is it accessible outside USA?
Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners[Dihydropyrimidine dehydrogenase deficiency screening for management of patients receiving a fluoropyrimidine: Results of two national practice surveys addressed to clinicians and biologists].
Bulletin du cancerThe Prevalence of DPYD*9A(c.85T>C) Genotype and the Genotype-Phenotype Correlation in Patients with Gastrointestinal Malignancies Treated With Fluoropyrimidines: Updated Analysis.
Clinical colorectal cancerSevere adverse events due to dihydropyrimidine dehydrogenase deficiency in a Japanese patient with colon cancer taking capecitabine: a case report.
International cancer conference journalFluoropyrimidines and DPD testing: is there truly an inexorable link?
European journal of cancer (Oxford, England : 1990)Three different polymorphisms of the DPYD gene associated with severe toxicity following administration of 5-FU: a case report.
Journal of medical case reportsCytomegalovirus enterocolitis in a patient with dihydropyrimidine dehydrogenase deficiency after capecitabine treatment: A case report.
International journal of surgery case reportsDihydropyrimidine dehydrogenase deficiency as a cause of fatal 5-Fluorouracil toxicity.
Autopsy & case reports5-Fluorouracil rechallenge after 5-fluorouracil-induced hyperammonemic encephalopathy.
Anti-cancer drugsEffectiveness and safety of reduced-dose fluoropyrimidine therapy in patients carrying the DPYD*2A variant: A matched pair analysis.
International journal of cancer[A Case of Colon Cancer with DPD Deficiency That Showed Severe Myelosuppression by CapeOX Adjuvant Chemotherapy after Colon Resection].
Gan to kagaku ryoho. Cancer & chemotherapyStandard fluoropyrimidine dosages in chemoradiation therapy result in an increased risk of severe toxicity in DPYD variant allele carriers.
European journal of cancer (Oxford, England : 1990)Dihydropyrimidine Dehydrogenase Deficiency: Homozygosity for an Extremely Rare Variant in DPYD due to Uniparental Isodisomy of Chromosome 1.
JIMD reportsCost Implications of Reactive Versus Prospective Testing for Dihydropyrimidine Dehydrogenase Deficiency in Patients With Colorectal Cancer: A Single-Institution Experience.
Dose-response : a publication of International Hormesis Society[5-fluorouracil therapeutic drug monitoring: Update and recommendations of the STP-PT group of the SFPT and the GPCO-Unicancer].
Bulletin du cancerPredicting fluoropyrimidine-related toxicity: turning wish to will, the PAMM-EORTC position.
Annals of oncology : official journal of the European Society for Medical OncologyPrompt treatment with uridine triacetate improves survival and reduces toxicity due to fluorouracil and capecitabine overdose or dihydropyrimidine dehydrogenase deficiency.
Toxicology and applied pharmacologyTopical application of 5-fluorouracil 5 percent cream associated with severe neutropenia: discussion of a case and review of systemic reactions after topical treatment with 5-fluorouracil.
Dermatology online journalCapecitabine Toxicity and Dihydropyrimidine Dehydrogenase Deficiency.
American journal of therapeuticsPreliminary Evidence for Enhanced Thymine Absorption: A Putative New Phenotype Associated With Fluoropyrimidine Toxicity in Cancer Patients.
Therapeutic drug monitoringGenome sequencing reveals a novel genetic mechanism underlying dihydropyrimidine dehydrogenase deficiency: A novel missense variant c.1700G>A and a large intragenic inversion in DPYD spanning intron 8 to intron 12.
Human mutationTolerability, Safety, and Outcomes of Neoadjuvant Chemoradiotherapy With Capecitabine for Patients Aged ≥ 70 Years With Locally Advanced Rectal Cancer.
Clinical colorectal cancer[Requirement of DPD deficiency screening before prescription of fluoropyrimidines].
Bulletin du cancerDPD functional tests in plasma, fresh saliva and dried saliva samples as predictors of 5-fluorouracil exposure and occurrence of drug-related severe toxicity.
Clinical biochemistryFluoropyrimidine-induced cardiotoxicity.
Critical reviews in oncology/hematology[Dihydropyrimidine dehydrogenase deficiency causes severe adverse effects of capecitabine].
Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology[Dihydropyrimidine déhydrogenase (DPD) deficiency screening and securing of fluoropyrimidine-based chemotherapies: Update and recommendations of the French GPCO-Unicancer and RNPGx networks].
Bulletin du cancerLife-Threatening Reaction with Topical 5-Fluorouracil.
Drug safety - case reportsPRIMUM NON NOCERE: now and again an echo of DPD with capecitabine.
Cancer chemotherapy and pharmacologySuccessful use of uridine triacetate (Vistogard) three weeks after capecitabine in a patient with homozygous dihydropyrimidine dehydrogenase mutation: A case report and review of the literature.
Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy PractitionersCapecitabine-based treatment of a patient with a novel DPYD genotype and complete dihydropyrimidine dehydrogenase deficiency.
International journal of cancerPrevention of 5-fluorouracil-induced early severe toxicity by pre-therapeutic dihydropyrimidine dehydrogenase deficiency screening: The multiparametric approach is not convincing.
Seminars in oncologyA simple and fast LC-MS/MS method with a very high sensitivity for the measurement of raltitrexed in human plasma.
Journal of chromatography. B, Analytical technologies in the biomedical and life sciencesPretreatment serum uracil concentration as a predictor of severe and fatal fluoropyrimidine-associated toxicity.
British journal of cancerPrevention of 5-fluorouracil-induced early severe toxicity by pre-therapeutic dihydropyrimidine dehydrogenase deficiency screening: Assessment of a multiparametric approach.
Seminars in oncologyDihydropyrimidine Dehydrogenase Deficiency: Metabolic Disease or Biochemical Phenotype?
JIMD reportsCapecitabine-Induced Severe Toxicity Secondary to DPD Deficiency and Successful Treatment with Low Dose 5-Fluorouracil.
Journal of gastrointestinal cancerSevere fluoropyrimidine toxicity due to novel and rare DPYD missense mutations, deletion and genomic amplification affecting DPD activity and mRNA splicing.
Biochimica et biophysica acta. Molecular basis of diseaseRecommendation on testing for dihydropyrimidine dehydrogenase deficiency in the ESMO consensus guidelines for the management of patients with metastatic colorectal cancer.
Annals of oncology : official journal of the European Society for Medical OncologyEmergency use of uridine triacetate for the prevention and treatment of life-threatening 5-fluorouracil and capecitabine toxicity.
CancerPatients homozygous for DPYD c.1129-5923C>G/haplotype B3 have partial DPD deficiency and require a dose reduction when treated with fluoropyrimidines.
Cancer chemotherapy and pharmacologyCurrent insights into the impact of dihydropyrimidine dehydrogenase deficiency in patients receiving treatment with 5-fluorouracil.
Clinical advances in hematology & oncology : H&OBenefit of uridine triacetate (Vistogard) in rescuing severe 5-fluorouracil toxicity in patients with dihydropyrimidine dehydrogenase (DPYD) deficiency.
Cancer chemotherapy and pharmacologyDevelopment and validation of a rapid and sensitive UPLC-MS/MS method for determination of uracil and dihydrouracil in human plasma.
Journal of pharmaceutical and biomedical analysisPhenotypic and clinical implications of variants in the dihydropyrimidine dehydrogenase gene.
Biochimica et biophysica actaEvaluation of an oral uracil loading test to identify DPD-deficient patients using a limited sampling strategy.
British journal of clinical pharmacologyBeating the odds: efficacy and toxicity of dihydropyrimidine dehydrogenase-driven adaptive dosing of 5-FU in patients with digestive cancer.
British journal of clinical pharmacologyToxicity Associated with Capecitabine in Patients Suffering from Dihydropyrimidine Dehydrogenase Deficiency.
ChemotherapyPersonalizing chemotherapy dosing using pharmacological methods.
Cancer chemotherapy and pharmacology[PHARMACOGENOMICS AND PERSONALIZED MEDICINE: TOWARDS A SYSTEMATIC GENOMIC SCREENING?].
Revue medicale de LiegeTranslating DPYD genotype into DPD phenotype: using the DPYD gene activity score.
PharmacogenomicsGenotyping of a family with a novel deleterious DPYD mutation supports the pretherapeutic screening of DPD deficiency with dihydrouracil/uracil ratio.
Clinical pharmacology and therapeuticsInfluence of metastatic disease on the usefulness of uracil pharmacokinetics as a screening tool for DPD activity in colorectal cancer patients.
Cancer chemotherapy and pharmacologyLethal 5-fluorouracil toxicity in a colorectal patient with severe dihydropyrimidine dehydrogenase (DPD) deficiency.
International journal of colorectal diseaseDPD and UGT1A1 deficiency in colorectal cancer patients receiving triplet chemotherapy with fluoropyrimidines, oxaliplatin and irinotecan.
British journal of clinical pharmacologyAssociation of new deletion/duplication region at chromosome 1p21 with intellectual disability, severe speech deficit and autism spectrum disorder-like behavior: an all-in approach to solving the DPYD enigma.
Translational neuroscience[Suspected dihydropyrimidine dehydrogenase deficiency in a patient receiving capecitabine as adjuvant chemotherapy after colon resection].
Gan to kagaku ryoho. Cancer & chemotherapyDihydropyrimidine dehydrogenase deficiency in two malaysian siblings with abnormal MRI findings.
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Referências e fontes
Bases de dados externas citadas neste artigo
Publicações científicas
Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.
- 5-Fluorouracil-induced acute leukoencephalopathy in the absence of dihydropyrimidine dehydrogenase deficiency: A case report.Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners· 2026· PMID 41610218mais citado
- Functional studies of human variants in C. elegans link iron metabolism to DPD deficiency and 5-FU sensitivity.
- Clinical Implications of a Large-Scale Voluntary Preemptive DPYD Testing Program for Patients Planned for a Systemic Fluoropyrimidine: Preliminary Results.
- A Lack of Complete Linkage Disequilibrium Between c.1236G>A and c.1129-5923C>G HapB3 Variants of DPYD: A Call to Revise European Pharmacogenetic Guidelines.
- Suspected capecitabine-induced fatal toxicity in the context of a new DPYD variant.
- Toxicity of Capecitabine and Oxaliplatin as Adjuvant Therapy for Stage III Colorectal Cancer Patients With Diverting Stoma.
- Results of a phase II trial of short-course radiation and TASOX [trifluridine/tipiracil (TAS-102) plus oxaliplatin] chemotherapy in operable rectal cancer.
- Clinical Implications of Dihydropyrimidine Dehydrogenase Deficiency in GI and Hepatopancreaticobiliary Cancers Treated With Fluoropyrimidines: A Prospective Observational Study.
- Prevalence of uncommon side effects of 5-fluorouracil and capecitabine in Saudi patients with cancer: A cross-sectional observational study.
Bases de dados e fontes oficiais
Identificadores e referências canônicas usadas para montar este verbete.
- ORPHA:1675(Orphanet)
- OMIM OMIM:274270(OMIM)
- MONDO:0010130(MONDO)
- GARD:19(GARD (NIH))
- Variantes catalogadas(ClinVar)
- Busca completa no PubMed(PubMed)
- Q5276448(Wikidata)
Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.
Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar
