Drug-induced Fanconi syndrome associated with fumaric acid esters treatment for psoriasis: a case series
| العنوان: | Drug-induced Fanconi syndrome associated with fumaric acid esters treatment for psoriasis: a case series |
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| المؤلفون: | Robert Zietse, Jan Nico Bouwes Bavinck, Deepak M.W. Balak, H.B. Thio, Hendrik Arent Martino Neumann, Aiko P. J. de Vries, Jenny Hartman |
| المساهمون: | Dermatology, Internal Medicine |
| المصدر: | NDT Plus, 9(1), 82-89 Clinical Kidney Journal Clinical Kidney Journal, 9(1), 82-89. Oxford University Press |
| سنة النشر: | 2016 |
| مصطلحات موضوعية: | 0301 basic medicine, Nephrology, Glycosuria, medicine.medical_specialty, Urinalysis, fumarates, osteomalacia, Gastroenterology, hypophosphataemia, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Psoriasis, Internal medicine, medicine, Transplantation, Osteomalacia, medicine.diagnostic_test, business.industry, Fanconi syndrome, Tubulointerstitial Disease Diagnosis, medicine.disease, Discontinuation, Surgery, 030104 developmental biology, medicine.symptom, proteinuria, business, proximal tubular dysfunction |
| الوصف: | Background Fumaric acid esters (FAEs), an oral immunomodulating treatment for psoriasis and multiple sclerosis, have been anecdotally associated with proximal renal tubular dysfunction due to a drug-induced Fanconi syndrome. Few data are available on clinical outcomes of FAE-induced Fanconi syndrome. Methods Descriptive case series with two cases of Fanconi syndrome associated with FAE treatment diagnosed at two Dutch university nephrology departments, three cases reported at the Dutch and German national pharmacovigilance databases and six previously reported cases. Results All 11 cases involved female patients with psoriasis. The median age at the time of onset was 38 years [interquartile range (IQR) 37–46]. Patients received long-term FAEs treatment with a median treatment duration of 60 months (IQR 28–111). Laboratory tests were typically significant for low serum levels of phosphate and uric acid, while urinalysis showed glycosuria and proteinuria. Eight (73%) patients had developed a hypophosphataemic osteomalacia and three (27%) had pathological bone fractures. All patients discontinued FAEs, while four (36%) patients were treated with supplementation of phosphate and/or vitamin D. Five (45%) patients had persisting symptoms despite FAEs discontinuation. Conclusions FAEs treatment can cause drug-induced Fanconi syndrome, but the association has been reported infrequently. Female patients with psoriasis treated long term with FAEs seem to be particularly at risk. Physicians treating patients with FAEs should be vigilant and monitor for the potential occurrence of Fanconi syndrome. Measurement of the urinary albumin:total protein ratio is a suggested screening tool for tubular proteinuria in Fanconi syndrome. |
| وصف الملف: | application/pdf |
| تدمد: | 1753-0784 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e776ab967759d55afdd8fe2d079e46d2 https://doi.org/10.1093/ckj/sfv114 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....e776ab967759d55afdd8fe2d079e46d2 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 17530784 |
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