Korean J Nephrol.
2008 Jul;27(4):481-486.
A Case of Multiple Myeloma with Ameliorated Bone Pain after Treatment of Adult Fanconi Syndrome
- Affiliations
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- 1Department of Internal Medicine, College of Medicine Hallym University, Seoul, Korea.
- 2Department of Pathology, College of Medicine Hallym University, Seoul, Korea.
- 3Hallym University Kidney Research Institute, Seoul, Korea.
Abstract
- Adult Fanconi syndrome is characterized by variable abnormalities caused by renal proximal transport defects, resulting in glycosuria, aminoaciduria, bicarbonaturia, uricosuria and phosphaturia. A 57-year-old man with kappa-light chain multiple myeloma, undergoing chemotherapy with prednisolone and melphalan for 17 month, was admitted with spontaneous femoral neck fracture and was consulted due to polyuria and refractory metabolic acidosis immediately after hemiarthroplasty. The laboratory values showed normal anion gap metabolic acidosis with normal urinary anion gap, hypokalemia, hypouricemia, hypophosphatemia at the time of consultation. After partial correction of acidemia, the fractional excretion of HCO3- was 11.9%, it was interpreted as proximal renal tubular acidosis. 24-hour urine collection showed increased level of excretion for most aminoacids. Diffuse osteopenia and multiple compression fractures on spine were detected on radiological examinations. Also, osteoporosis and osteomalacia was suggested during his clinical course. After the diagnosis of Fanconi syndrome was made, treatment was started with sodium bicarbonate, potassium citrate, calcitriol, calcium carbonate along with phosphate rich diet. Laboratory abnormalities were corrected and refractory multiple bone pain was ameliorated with these treatment.
Keyword
MeSH Terms
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Acid-Base Equilibrium
Acidosis
Acidosis, Renal Tubular
Adult
Bone Diseases, Metabolic
Calcitriol
Calcium Carbonate
Diet
Fanconi Syndrome
Femoral Neck Fractures
Fractures, Compression
Glycosuria
Hemiarthroplasty
Humans
Hypokalemia
Hypophosphatemia
Hypophosphatemia, Familial
Melphalan
Middle Aged
Multiple Myeloma
Osteomalacia
Osteoporosis
Polyuria
Potassium Citrate
Prednisolone
Sodium Bicarbonate
Spine
Urine Specimen Collection
Calcitriol
Calcium Carbonate
Melphalan
Potassium Citrate
Prednisolone
Sodium Bicarbonate
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