Ifosfamide-induced Fanconi syndrome with diabetes insipidus

• Published in: The Korean journal of internal medicine 2014, 29(2), , pp.246-249
• Main Authors: Leem, Ah Young, Kim, Han Sang, Yoo, Byung Woo, Kang, Beo Deul, Kim, Min Hwan, Rha, Sun Young, Kim, Hyo Song
• Format: Article
• Language: English
• Subjects: Acidosis - chemically induced; Antineoplastic Agents, Alkylating - adverse effects; Case Report; Chemotherapy, Adjuvant; Diabetes Insipidus - chemically induced; Diabetes Insipidus - diagnosis; Diabetes Insipidus - therapy; Fanconi Syndrome - chemically induced; Fanconi Syndrome - diagnosis; Fanconi Syndrome - therapy; Fatal Outcome; Histiocytoma, Malignant Fibrous - drug therapy; Histiocytoma, Malignant Fibrous - pathology; Humans; Ifosfamide - adverse effects; Male; Middle Aged; Neoadjuvant Therapy - adverse effects; Time Factors; 내과학
• ISSN: 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2014.29.2.246

Ifosfamide-induced Fanconi syndrome is a rare complication that typically occurs in young patients due to a cumulative dose of ifosfamide > 40-60 g/m(2), a reduction in kidney mass, or concurrent cisplatin treatment. It is usually characterized by severe and fatal progression accompanied by type II proximal renal tubular dysfunction, as evidenced by glycosuria, proteinuria, electrolyte loss, and metabolic acidosis. Diabetes insipidus is also a rare complication of ifosfamide-induced renal disease. We herein describe a case involving a 61-year-old man who developed ifosfamide-induced Fanconi syndrome accompanied by diabetes insipidus only a few days after the first round of chemotherapy. He had no known risk factors. In addition, we briefly review the mechanisms and possible therapeutic options for this condition based on other cases in the literature. Patients who receive ifosfamide must be closely monitored for renal impairment to avoid this rare but fatal complication.