An Interesting Case of Acquired Renal Fanconi Syndrome
Authors
Subbiah Senthilnathan
Internal Medicine, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
Gunasekaran Nallusamy
Internal Medicine, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
Priyadarshini Varadaraj
Internal Medicine, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
Renal Fanconi syndrome (RFS) is a proximal tubular dysfunction characterized by abnormalities in the absorption of electrolytes and substances by the proximal tubule. It can manifest as proteinuria, glycosuria, aminoaciduria, phosphaturia, and proximal renal tubular acidosis (RTA) type 2. Heavy metal-induced nephrotoxicity from heavy metals such as iron, cadmium, mercury, and lead is a common risk factor for type 2 RTA. Environmental contamination or prolonged contact with pesticides, such as lead arsenate, Bordeaux mixture, and copper sulfate, may also contribute to heavy metal exposure. A 25-year-old female patient with RFS was diagnosed, and the bicarbonate loading test showed typical features of generalized proximal tubular dysfunction and proximal RTA. A metabolic disorder in the bone was the predominant feature, and renal wasting of phosphorus and calcium was linked to osteoporosis and increased intact parathyroid hormone (PTH) levels. Due to reports of zoledronate-induced RFS, calcitriol was administered instead of bisphosphates. Drug-induced nephrotoxicity is the most probable cause of adult-onset RFS. Acute tubulointerstitial nephritis is a plausible hypothesis, and treatment was based on observations and assessments that improved clinical outcomes. Ayurvedic medicine, popular in India due to its traditional roots and cultural aversion to artificial drugs, has high levels of heavy metal content.
Keywords: drug-induced nephrotoxicity, heavy metals induced, ayurvedic medicine, renal tubular acidosis, renal fanconi syndrome
Click on "Archives" to access the full archive of scientific preprints. You may use the categories and the search functionality to find select preprints you're interested in.
