Fanconi Syndrome Induced by Ifosfamide in a Young Adult with Ewing Sarcoma

Nitrogen mustards, including ifosfamide, have been used as antineoplastic agents since the mid-twentieth century. A rare but recognized complication of ifosfamide therapy is the development of type-II proximal renal tubular dysfunction, consistent with Fanconi syndrome. This adverse effect can occur at any age; however, it is more commonly described in pediatric populations, affecting up to 5% of children treated with ifosfamide. The purpose of the current report is to describe a case of a young adult male patient undergoing treatment with etoposide and ifosfamide for Ewing sarcoma. Upon admission, the patient presented with lower abdominal pain and hematuria; laboratory tests revealed electrolyte imbalances and urinary findings consistent with Fanconi syndrome. The patient received supportive care, including electrolyte replacement, and achieved full recovery.