{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T10:50:47Z","timestamp":1787223047577,"version":"build-2736575974"},"reference-count":12,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,1,4]],"date-time":"2012-01-04T00:00:00Z","timestamp":1325635200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:p><jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>anconi's syndrome is a serious condition characterized by type <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> proximal renal tubular dysfunction, with urinary loss of glucose, amino acids, phosphate, bicarbonate, and potassium. Ifosfamide\u2010induced <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>anconi's syndrome is reported in about 1.4\u20135% of children being treated for solid tumors, yet only a few cases have been reported in adults. We describe a 54\u2010year\u2010old man who came to the hospital with symptoms of neutropenic fever 4\u00a0days after his fourth cycle of ifosfamide and doxorubicin treatment for recurrent sarcoma with metastases to the lung. During admission, he was noted to have severe renal tubular dysfunction; ifosfamide\u2010induced nephrogenic diabetes insipidus and <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>anconi's syndrome were suspected. He received supportive therapy that resulted in incomplete resolution of signs and symptoms. The patient was discharged after a 5\u2010day hospital stay when his white blood cell count increased from 0.1\u20132.5\u00a0\u00d7\u00a010<jats:sup>3<\/jats:sup>\/mm<jats:sup>3<\/jats:sup> and his fever had resolved. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 7) between the patient's development of diabetes insipidus and <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>anconi's syndrome and his use of ifosfamide. This dual diagnosis of diabetes insipidus and <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>anconi's syndrome in an adult makes this case unusual, as well as therapeutically challenging. We conducted a review of the existing literature regarding ifosfamide\u2010induced <jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>anconi's syndrome and describe the proposed mechanisms and therapeutic options. This case suggests that patients treated with ifosfamide should be monitored closely for renal function to identify, and perhaps prevent, these rare adverse events. Preliminary animal models show promise for adding <jats:styled-content style=\"fixed-case\"><jats:italic>N<\/jats:italic><\/jats:styled-content>\u2010acetylcysteine to ifosfamide treatment, but more research is necessary before using this drug as a therapeutic option.<\/jats:p>","DOI":"10.1002\/phar.1013","type":"journal-article","created":{"date-parts":[[2012,9,5]],"date-time":"2012-09-05T03:32:40Z","timestamp":1346815960000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["<scp>F<\/scp>anconi's Syndrome and Nephrogenic Diabetes Insipidus in an Adult Treated with Ifosfamide"],"prefix":"10.1002","volume":"32","author":[{"given":"Amanda I.","family":"Ingemi","sequence":"first","affiliation":[{"name":"Department of Pharmacy Henry Ford Hospital Detroit Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasile M.","family":"Bota","sequence":"additional","affiliation":[{"name":"Department of Medicine Roger Williams Medical Center Providence Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anyeri","family":"Peguero","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine Boston Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Charpentier","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice University of Rhode Island College of Pharmacy Kingston Rhode Island"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,1,4]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1517\/14740330902808169"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200124010-00003"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trsl.2007.02.001"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.3109\/08860229509037619"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-007-0275-5"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/13.6.1547"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1021\/mp100329u"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1981.154"},{"key":"e_1_2_5_10_1","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1177\/106002809502900607","article-title":"Ifosfamide\u2010induced Fanconi syndrome","volume":"29","author":"Garcia AA","year":"1995","journal-title":"Ann Pharmacother"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000146568.82353.04"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/bjp.2008.15"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22364"}],"container-title":["Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2FPHAR.1013","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2FPHAR.1013","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/PHAR.1013","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T14:49:40Z","timestamp":1761058180000},"score":1,"resource":{"primary":{"URL":"https:\/\/accpjournals.onlinelibrary.wiley.com\/doi\/10.1002\/PHAR.1013"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,1]]},"references-count":12,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2012,1]]}},"alternative-id":["10.1002\/PHAR.1013"],"URL":"https:\/\/doi.org\/10.1002\/phar.1013","archive":["Portico"],"relation":{},"ISSN":["0277-0008","1875-9114"],"issn-type":[{"value":"0277-0008","type":"print"},{"value":"1875-9114","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,1]]},"assertion":[{"value":"2012-01-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}