Department of Hematology-Oncology, Chonnam National University Medical School, Gwangju, Korea.
Cancer Res Treat. 2010 Dec;42(4):244-6. doi: 10.4143/crt.2010.42.4.244. Epub 2010 Dec 31.
The alkylating agent ifosfamide is an anti-neoplastic used to treat various pediatric and adult malignancies. Its potential urologic toxicities include glomerulopathy, tubulopathy and hemorrhagic cystitis. This report describes a case of proximal renal tubular dysfunction and hemorrhagic cystitis in a 67-year-old male given ifosfamide for epitheloid sarcoma. He was also receiving an oral hypoglycemic agent for type 2 diabetes mellitus and had a baseline glomerular filtration rate of 51.5 mL/min/1.73 m(2). Despite mesna prophylaxis, the patient experienced dysuria and gross hematuria after a single course of ifosfamide plus adriamycin. The abrupt renal impairment and serum/urine electrolyte imbalances that ensued were consistent with Fanconi's syndrome. However, normal renal function and electrolyte status were restored within 14 days, simply through supportive measures. A score of 8 by Naranjo adverse drug reaction probability scale indicated these complications were most likely treatment-related, although they developed without known predisposing factors. The currently undefined role of diabetic nephropathy in adult ifosfamide nephrotoxicity merits future investigation.
烷化剂异环磷酰胺是一种用于治疗各种儿科和成人恶性肿瘤的抗肿瘤药物。其潜在的泌尿系统毒性包括肾小球病、肾小管病和出血性膀胱炎。本报告描述了一例给予异环磷酰胺治疗上皮样肉瘤的 67 岁男性发生近端肾小管功能障碍和出血性膀胱炎的病例。他还因 2 型糖尿病接受口服降糖药治疗，肾小球滤过率基线为 51.5 mL/min/1.73 m(2)。尽管给予美司钠预防，但该患者在单次使用异环磷酰胺加阿霉素后出现尿痛和肉眼血尿。随后出现的急性肾功能损害和血清/尿液电解质失衡与范可尼综合征一致。然而，通过支持治疗，肾功能和电解质状态在 14 天内恢复正常。Naranjo 不良药物反应概率量表评分为 8 分表明这些并发症极有可能与治疗相关，尽管它们在没有已知诱发因素的情况下发生。糖尿病肾病在成人异环磷酰胺肾毒性中的目前尚不清楚的作用值得进一步研究。
