Korean J Intern Med.  2014 Mar;29(2):246-249. 10.3904/kjim.2014.29.2.246.

Ifosfamide-induced Fanconi syndrome with diabetes insipidus

• Leem AY
• Kim HS
• Yoo BW
• Kang BD
• Kim MH
• Rha SY
• Kim HS

• KMID: 1792043
• DOI: http://doi.org/10.3904/kjim.2014.29.2.246

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/m2, 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.

Keyword

Ifosfamide; Fanconi syndrome; Diabetes insipidus

MeSH Terms

Acidosis/chemically induced
Antineoplastic Agents, Alkylating/*adverse effects
Chemotherapy, Adjuvant
Diabetes Insipidus/*chemically induced/diagnosis/therapy
Fanconi Syndrome/*chemically induced/diagnosis/therapy
Fatal Outcome
Histiocytoma, Malignant Fibrous/*drug therapy/pathology
Humans
Ifosfamide/*adverse effects
Male
Middle Aged
Neoadjuvant Therapy/*adverse effects
Time Factors
Antineoplastic Agents, Alkylating
Ifosfamide