[Persistent electrolyte deficiency in an oncology patient].

Area of Science:

• Oncology
• Nephrology
• Pharmacology

Background:

• A patient with dedifferentiated mediastinal-thoracic liposarcoma experienced electrolyte disturbances during chemotherapy.
• Initial suspicion of refeeding syndrome was based on hypokalemia, hypomagnesemia, and hypophosphatemia.
• Prolonged electrolyte abnormalities and normoglycemic glucosuria suggested a different diagnosis.

Purpose of the Study:

• To identify the cause of electrolyte disturbances in a patient undergoing chemotherapy.
• To highlight the early detection of proximal tubular dysfunction.
• To emphasize the importance of urine diagnostics in managing chemotherapy side effects.

Main Methods:

• Case report of a 47-year-old patient.
• Clinical observation of electrolyte levels, urine glucose, and protein.
• Diagnosis of partial Fanconi syndrome based on symptoms and lab findings.

Main Results:

• The patient was diagnosed with partial Fanconi syndrome, a proximal tubular dysfunction.
• This condition is a known complication of Ifosfamide therapy.
• Standard kidney function markers (e.g., eGFR) were normal early on, underscoring the significance of other indicators.

Conclusions:

• Partial Fanconi syndrome is a critical adverse effect of Ifosfamide chemotherapy.
• Early urine diagnostics are vital for recognizing this condition, even with normal eGFR.
• Prompt identification aids in managing chemotherapy-induced tubular dysfunction.