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Acquired Fanconi syndrome
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Acquired Fanconi syndrome

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Contributors: Amirah Khan MD, Catherine Moore MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Acquired Fanconi syndrome is the generalized dysfunction of the proximal tubule of the kidney caused by toxic exposure to certain drugs and heavy metals as well as monoclonal gammopathy. This disorder can occur in children and adults and is dependent on toxin exposure history. Common drugs that cause acquired Fanconi syndrome include aminoglycoside antibiotics, tetracycline antibiotics, chemotherapy agents (cisplatin, ifosfamide, carboplatin), antiviral drugs (tenofovir, adefovir), and anticonvulsant agents (valproic acid). Heavy metals such as cadmium, lead, mercury, platinum, and uranium are also implicated in acquired Fanconi syndrome. Monoclonal gammopathy due to multiple myeloma or monoclonal gammopathy of undetermined significance (MGUS) tends to occur in the adult population only.

Clinical manifestations include normoglycemic glycosuria, aminoaciduria, hypophosphatemia, hypokalemia, hypouricemia, and proximal renal tubular acidosis (type 2 renal tubular acidosis). Growth failure is a common presentation in children due to electrolyte deficiencies. Complications such as rickets, osteomalacia, muscle weakness, and confusion / lethargy can occur. Diagnosis is made with laboratory and urine testing. Treatment includes withdrawal of the offending agent, reversal of acidosis, and replacement of fluids and electrolytes.

Codes

ICD10CM:
E72.09 – Other disorders of amino-acid transport

SNOMEDCT:
236467001 – Acquired fanconi syndrome

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 07/26/2019
Last Updated: 07/29/2019
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Acquired Fanconi syndrome
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Acquired Fanconi syndrome : Fatigue, Bone pain, Hypokalemia, Hypophosphatemia, Muscle weakness, Anticonvulsant, K decreased
Copyright © 2019 VisualDx®. All rights reserved.