文献类型：期刊文献

英文题名：Fanconi syndrome developing and worsening during anti-myeloma therapy in multiple myeloma: a case report and literature review

作者：Zhang, Pengpeng[1];Li, Peng[2];Zhang, Xinlian[1];Xia, Yang[1];Niu, Yujuan[1];Liu, Xinguang[2];Qin, Xuemei[2]

第一作者：张萍萍

通信作者：Qin, XM[1]

机构：[1]Gansu Univ Chinese Med, Lanzhou Peoples Hosp 1, Dept Hematol, Clin Med Coll 2, Lanzhou, Peoples R China;[2]Shandong Univ, Qilu Hosp, Cheeloo Coll Med, Dept Hematol, Jinan, Peoples R China

第一机构：甘肃中医药大学

通信机构：[1]corresponding author), Shandong Univ, Qilu Hosp, Cheeloo Coll Med, Dept Hematol, Jinan, Peoples R China.

年份：2026

卷号：16

外文期刊名：FRONTIERS IN ONCOLOGY

收录：;Scopus(收录号：2-s2.0-105034053988);WOS:【SCI-EXPANDED(收录号:WOS:001722347400001)】；

基金：The author(s) declared that financial support was received for this work and/or its publication. Lanzhou Health and Wellness Science and Technology Development Funding Project (Project No.: A2024016).

语种：英文

外文关键词：anti-myeloma therapy; autologous hematopoietic stem cell transplantation; electrolyte replacement; Fanconi syndrome; multiple myeloma

摘要：Background Fanconi syndrome (FS) is a rare renal complication of monoclonal gammopathies including multiple myeloma (MM), typically diagnosed before or at the time of MM presentation. Onset and progression of FS during anti-myeloma treatment are extremely rare and easily misdiagnosed, resulting in delayed electrolyte correction and clinical deterioration.Case presentation We report a 55-year-old woman with kappa light chain MM who developed FS during induction therapy and experienced recurrence after autologous stem cell transplantation (ASCT). Initial workup showed subclinical tubular dysfunction with renal glycosuria and elevated tubular markers, which was initially overlooked. Shortly after induction therapy, she developed severe and recurrent hypokalemia and hypophosphatemia accompanied by progressive gastrointestinal symptoms despite hematological remission. A multidisciplinary consultation confirmed MM-associated FS. Electrolyte replacement, particularly phosphate supplementation, rapidly relieved her symptoms. With ongoing anti-myeloma therapy, glycosuria gradually resolved. Following ASCT, FS recurred but resolved with supportive care. The patient has remained in remission during continued follow-up.Conclusion Anti-myeloma therapy may transiently induce or exacerbate FS, especially in patients with pre-existing renal tubular dysfunction, likely due to synergistic tubular toxicity of anti-myeloma agents. Early recognition, frequent electrolyte monitoring and prompt correction, as well as multidisciplinary collaboration, are crucial for optimal management of FS.