Abstract | Background: Methods: This retrospective study analyzed 1728 cases of allogeneic kidney transplant patients admitted to the Second Xiangya Hospital of Central South University from July 2016 to January 2021. Two patients with Fanconi syndrome secondary to drugs, adefovir dipivoxil (ADV) and tacrolimus, were screened. We summarized the diagnostic process, clinical data, and prognosis. Results: The onset of Fanconi syndrome secondary to ADV after renal transplantation was insidious, and the condition developed after long-term medication (>10 years). It mainly manifested as bone pain, osteomalacia, and scoliosis in the late stage and was accompanied by obvious proximal renal tubular damage (severe hypophosphatemia, hypokalemia, hypocalcemia, hypouricemia, glycosuria, protein urine, acidosis, etc.) and renal function damage (increased creatinine and azotemia). The pathological findings included mitochondrial swelling and deformity in renal tubular epithelial cells. The above symptoms and signs were relieved after drug withdrawal, but the scoliosis was difficult to rectify. Fanconi syndrome secondary to tacrolimus has a single manifestation, increased creatinine, which can be easily confused with tacrolimus nephrotoxicity. However, it is often ineffective to reduce the dose of tacrolomus, and proximal renal failure can be found in the later stage of disease development. There was no abnormality in the bone metabolism index and imageological examination findings. The creatinine level decreased rapidly, the proximal renal tubule function returned to normal, and no severe electrolyte imbalance or urinary component loss occurred when the immunosuppression was changed from tacrolimus to cyclosporine A. Conclusions:
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Authors | Zhouqi Tang, Tengfang Li, Helong Dai, Chen Feng, Xubiao Xie, Fenghua Peng, Gongbin Lan, Shaojie Yu, Yu Wang, Chunhua Fang, Manhua Nie, Xiaoqiong Yuan, Xiaotian Tang, Xin Jiang, Xuejing Zhu, Yuxi Fan, Jiawei Peng, Siyu Sun, Mingda Zhong, Hedong Zhang, Longkai Peng |
Journal | Frontiers in immunology
(Front Immunol)
Vol. 13
Pg. 979983
( 2022)
ISSN: 1664-3224 [Electronic] Switzerland |
PMID | 36059468
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2022 Tang, Li, Dai, Feng, Xie, Peng, Lan, Yu, Wang, Fang, Nie, Yuan, Tang, Jiang, Zhu, Fan, Peng, Sun, Zhong, Zhang and Peng. |
Chemical References |
- Antiviral Agents
- Creatinine
- Tacrolimus
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Topics |
- Allografts
- Antiviral Agents
(adverse effects)
- Creatinine
- Fanconi Anemia
(pathology)
- Fanconi Syndrome
(chemically induced, diagnosis, therapy)
- Humans
- Kidney Transplantation
(adverse effects)
- Kidney Tubules, Proximal
(pathology)
- Renal Insufficiency
- Retrospective Studies
- Scoliosis
(chemically induced, pathology)
- Tacrolimus
(adverse effects)
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