Vayzband Vlad, Mira Michael, Williams Karlene
Internal Medicine, Overlook Medical Center, Summit, USA.
Cureus. 2024 Jul 4;16(7):e63862. doi: 10.7759/cureus.63862. eCollection 2024 Jul.
Antineoplastic agents are often associated with a wide range of side effects, caused by either direct toxicity or indirect through their metabolism. Ifosfamide is a cytotoxic, antineoplastic medication that is known to cause a direct tubular injury with an associated normal anion gap metabolic acidosis due to type 1 or type 2 renal tubular acidosis (RTA). The manifestations and approach to its diagnosis have been well established. However, we present a case in which a patient presented with acute symptomatic hypokalemia in the setting of ongoing ifosfamide use for metastatic osteosarcoma but without the typical laboratory findings. The clinical- and laboratory-driven diagnosis of suspected type 3 renal tubular acidosis involving proximal and distal segments is suggested by this case report.
抗肿瘤药物常常伴有各种各样的副作用，这些副作用要么是由直接毒性引起，要么是通过其代谢间接导致。异环磷酰胺是一种细胞毒性抗肿瘤药物，已知它会由于1型或2型肾小管酸中毒（RTA）导致直接肾小管损伤，并伴有正常阴离子间隙代谢性酸中毒。其临床表现及诊断方法已得到充分确立。然而，我们报告了一例患者，该患者在持续使用异环磷酰胺治疗转移性骨肉瘤的过程中出现急性症状性低钾血症，但没有典型的实验室检查结果。本病例报告提示了通过临床和实验室检查对疑似涉及近端和远端节段的3型肾小管酸中毒进行诊断。
