A case of ifosfamide-induced acute kidney injury, Fanconi syndrome, and nephrogenic diabetes insipidus.

IF 1 Q4 UROLOGY & NEPHROLOGY
CEN Case Reports Pub Date : 2024-06-01 Epub Date: 2023-10-28 DOI:10.1007/s13730-023-00829-z
Summer Hoang, Thejeswi Pujar, Ezequiel Bellorin-Font, John C Edwards, Kana N Miyata
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引用次数: 0

Abstract

Ifosfamide, a cytotoxic antineoplastic drug, can induce rare complications of Fanconi syndrome and nephrogenic diabetes insipidus (DI). Ifosfamide-induced Fanconi syndrome tends to occur in patients with certain risk factors including young age, high cumulative ifosfamide dose, and coadministration of cisplatin. Nephrogenic DI causes polyuria from impaired urinary concentrating ability due to resistance to arginine vasopressin (AVP) at the collecting duct. These complications are serious and potentially fatal. Here, we describe a case of a middle-aged man without risk factors who was admitted for the management of acute kidney injury and electrolyte derangements after his fourth cycle of chemotherapy including ifosfamide for synovial sarcoma. He was found to have hypokalemia, hypophosphatemia, renal glycosuria, and aminoaciduria, likely from Fanconi syndrome, which were managed by electrolyte replacement therapy. In addition, polyuria and hypernatremia were considered due to nephrogenic DI, which partially responded to desmopressin treatment. This case highlights the importance of the routine electrolytes monitoring after ifosfamide treatment.

一例异环磷酰胺引起的急性肾损伤、范科尼综合征和肾源性尿崩症。
Ifosfamide是一种细胞毒性抗肿瘤药物,可引起罕见的Fanconi综合征和肾源性尿崩症(DI)并发症。Ifosfamide诱导的Fanconi综合征往往发生在具有某些危险因素的患者中,包括年轻、高累积异环磷酰胺剂量和联合使用顺铂。肾源性DI由于收集管对精氨酸加压素(AVP)的抵抗而导致尿液浓缩能力受损,从而导致多尿。这些并发症很严重,可能致命。在这里,我们描述了一个没有危险因素的中年男子的病例,他在接受了包括异环磷酰胺治疗滑膜肉瘤在内的第四个周期的化疗后,因急性肾损伤和电解质紊乱而入院治疗。他被发现患有低钾血症、低磷血症、肾性糖尿和氨基酸尿,可能是由Fanconi综合征引起的,这些都是通过电解质替代疗法治疗的。此外,多尿和高钠血症被认为是由于肾源性DI,其对去氨加压素治疗有部分反应。该病例强调了异环磷酰胺治疗后常规电解质监测的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CEN Case Reports
CEN Case Reports UROLOGY & NEPHROLOGY-
CiteScore
1.90
自引率
0.00%
发文量
80
期刊介绍: Clinical and Experimental Nephrology (CEN) Case Reports is a peer-reviewed online-only journal, officially published biannually by the Japanese Society of Nephrology (JSN).  The journal publishes original case reports in nephrology and related areas.  The purpose of CEN Case Reports is to provide clinicians and researchers with a forum in which to disseminate their personal experience to a wide readership and to review interesting cases encountered by colleagues all over the world, from whom contributions are welcomed.
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