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Ifosfamide-induced Fanconi syndrome with diabetes insipidus

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초록

Ifosfamide-induced Fanconi syndrome is a rare complication that typically occursin young patients due to a cumulative dose of ifosfamide > 40–60 g/m2, a reductionin kidney mass, or concurrent cisplatin treatment. It is usually characterizedby severe and fatal progression accompanied by type II proximal renal tubulardysfunction, as evidenced by glycosuria, proteinuria, electrolyte loss, and metabolicacidosis. Diabetes insipidus is also a rare complication of ifosfamide-inducedrenal disease. We herein describe a case involving a 61-year-old man whodeveloped ifosfamide-induced Fanconi syndrome accompanied by diabetes insipidusonly a few days after the first round of chemotherapy. He had no known riskfactors. In addition, we briefly review the mechanisms and possible therapeuticoptions for this condition based on other cases in the literature. Patients whoreceive ifosfamide must be closely monitored for renal impairment to avoid thisrare but fatal complication.

Abstract

Ifosfamide-induced Fanconi syndrome is a rare complication that typically occursin young patients due to a cumulative dose of ifosfamide > 40–60 g/m2, a reductionin kidney mass, or concurrent cisplatin treatment. It is usually characterizedby severe and fatal progression accompanied by type II proximal renal tubulardysfunction, as evidenced by glycosuria, proteinuria, electrolyte loss, and metabolicacidosis. Diabetes insipidus is also a rare complication of ifosfamide-inducedrenal disease. We herein describe a case involving a 61-year-old man whodeveloped ifosfamide-induced Fanconi syndrome accompanied by diabetes insipidusonly a few days after the first round of chemotherapy. He had no known riskfactors. In addition, we briefly review the mechanisms and possible therapeuticoptions for this condition based on other cases in the literature. Patients whoreceive ifosfamide must be closely monitored for renal impairment to avoid thisrare but fatal complication.

참고문헌 (10)

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  9. Chen N, "N-Acetylcysteine prevents ifosfamide-induced nephrotoxicity in rats", Br J Pharmacol, 153, pp.1364~1372 (2008)
  10. Hanly L, "Ifosfamide nephrotoxicity in children: a mechanistic base for pharmacological prevention", Expert Opin Drug Saf, 8, pp.155~168 (2009)

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