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异环磷酰胺诱导的伴有尿崩症的范科尼综合征。

Ifosfamide-induced Fanconi syndrome with diabetes insipidus.

作者信息

Leem Ah Young, Kim Han Sang, Yoo Byung Woo, Kang Beo Deul, Kim Min Hwan, Rha Sun Young, Kim Hyo Song

机构信息

Division of Medical Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Korean J Intern Med. 2014 Mar;29(2):246-9. doi: 10.3904/kjim.2014.29.2.246. Epub 2014 Feb 27.

Abstract

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.

摘要

异环磷酰胺诱导的范科尼综合征是一种罕见的并发症,通常发生在年轻患者中,原因是异环磷酰胺累积剂量>40 - 60 g/m²、肾脏质量减少或同时进行顺铂治疗。其通常表现为严重且致命的进展,并伴有II型近端肾小管功能障碍,表现为糖尿、蛋白尿、电解质丢失和代谢性酸中毒。尿崩症也是异环磷酰胺诱导的肾脏疾病的一种罕见并发症。我们在此描述一例病例,一名61岁男性在第一轮化疗后仅几天就发生了异环磷酰胺诱导的范科尼综合征并伴有尿崩症。他没有已知的危险因素。此外,我们根据文献中的其他病例简要回顾了这种情况的机制和可能的治疗选择。接受异环磷酰胺治疗的患者必须密切监测肾功能损害,以避免这种罕见但致命的并发症。

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