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Published in: BMC Nephrology 1/2013

Open Access 01-12-2013 | Case report

Acquired Fanconi syndrome in patients with Legionella pneumonia

Authors: Naoko Kinoshita-Katahashi, Hirotaka Fukasawa, Sayaka Ishigaki, Shinsuke Isobe, Shiro Imokawa, Yoshihide Fujigaki, Ryuichi Furuya

Published in: BMC Nephrology | Issue 1/2013

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Abstract

Background

Hyponatremia is often observed in patients with Legionella pneumonia. However, other electrolyte abnormalities are uncommon and the mechanism remains to be clarified.

Case presentation

We experienced two male cases of acquired Fanconi syndrome associated with Legionella pneumonia. The laboratory findings at admission showed hypophosphatemia, hypokalemia, hypouricemia and/or hyponatremia. In addition, they had the generalized dysfunction of the renal proximal tubules presenting decreased tubular reabsorption of phosphate (%TRP), increased fractional excretion of potassium (FEK) and uric acid (FEUA), low-molecular-weight proteinuria, panaminoaciduria and glycosuria. Therefore, they were diagnosed as Fanconi syndrome. Treatment for Legionella pneumonia with antibiotics resulted in the improvement of all serum electrolyte abnormalities and normalization of the %TRP, FEK, FEUA, low-molecular-weight proteinuria, panaminoaciduria and glycosuria, suggesting that Legionella pneumophila infection contributed to the pathophysiology of Fanconi syndrome.

Conclusion

To the best of our knowledge, this is the first report demonstrating Fanconi syndrome associated with Legionella pneumonia.
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Literature
1.
go back to reference Gaboardi F, Case L, Edefonti A, De Vecchi A, Graziani G: [Fanconi syndrome]. Minerva Med. 1979, 70: 3075-3083.PubMed Gaboardi F, Case L, Edefonti A, De Vecchi A, Graziani G: [Fanconi syndrome]. Minerva Med. 1979, 70: 3075-3083.PubMed
2.
go back to reference Maldonado JE, Velosa JA, Kyle RA, Wagoner RD, Holley KE, Salassa RM: Fanconi syndrome in adults. A manifestation of a latent form of myeloma. Am J Med. 1975, 58: 354-364. 10.1016/0002-9343(75)90601-4.CrossRefPubMed Maldonado JE, Velosa JA, Kyle RA, Wagoner RD, Holley KE, Salassa RM: Fanconi syndrome in adults. A manifestation of a latent form of myeloma. Am J Med. 1975, 58: 354-364. 10.1016/0002-9343(75)90601-4.CrossRefPubMed
3.
go back to reference Cachat F, Nenadov-Beck M, Guignard JP: Occurrence of an acute Fanconi syndrome following cisplatin chemotherapy. Medical and Pediatric Oncology. 1998, 31: 40-41. 10.1002/(SICI)1096-911X(199807)31:1<40::AID-MPO11>3.0.CO;2-6.CrossRefPubMed Cachat F, Nenadov-Beck M, Guignard JP: Occurrence of an acute Fanconi syndrome following cisplatin chemotherapy. Medical and Pediatric Oncology. 1998, 31: 40-41. 10.1002/(SICI)1096-911X(199807)31:1<40::AID-MPO11>3.0.CO;2-6.CrossRefPubMed
4.
go back to reference Lino M, Binaut R, Noel LH, Patey N, Rustin P, Daniel L, Serpaggi J, Varaut A, Vanhille P, Knebelmann B, et al: Tubulointerstitial nephritis and Fanconi syndrome in primary biliary cirrhosis. Am J Kidney Dis. 2005, 46: e41-46. 10.1053/j.ajkd.2005.05.021.CrossRefPubMed Lino M, Binaut R, Noel LH, Patey N, Rustin P, Daniel L, Serpaggi J, Varaut A, Vanhille P, Knebelmann B, et al: Tubulointerstitial nephritis and Fanconi syndrome in primary biliary cirrhosis. Am J Kidney Dis. 2005, 46: e41-46. 10.1053/j.ajkd.2005.05.021.CrossRefPubMed
5.
go back to reference Yu VL, Kroboth FJ, Shonnard J, Brown A, McDearman S, Magnussen M: Legionnaires’ disease: new clinical perspective from a prospective pneumonia study. Am J Med. 1982, 73: 357-361. 10.1016/0002-9343(82)90727-6.CrossRefPubMed Yu VL, Kroboth FJ, Shonnard J, Brown A, McDearman S, Magnussen M: Legionnaires’ disease: new clinical perspective from a prospective pneumonia study. Am J Med. 1982, 73: 357-361. 10.1016/0002-9343(82)90727-6.CrossRefPubMed
7.
go back to reference Emma F, Bertini E, Salviati L, Montini G: Renal involvement in mitochondrial cytopathies. Pediatr Nephrol. 2012, 27: 539-550. 10.1007/s00467-011-1926-6.CrossRefPubMed Emma F, Bertini E, Salviati L, Montini G: Renal involvement in mitochondrial cytopathies. Pediatr Nephrol. 2012, 27: 539-550. 10.1007/s00467-011-1926-6.CrossRefPubMed
8.
go back to reference Niaudet P, Rotig A: The kidney in mitochondrial cytopathies. Kidney Int. 1997, 51: 1000-1007. 10.1038/ki.1997.140.CrossRefPubMed Niaudet P, Rotig A: The kidney in mitochondrial cytopathies. Kidney Int. 1997, 51: 1000-1007. 10.1038/ki.1997.140.CrossRefPubMed
9.
go back to reference Campos Y, Garcia-Silva T, Barrionuevo CR, Cabello A, Muley R, Arenas J: Mitochondrial DNA deletion in a patient with mitochondrial myopathy, lactic acidosis, and stroke-like episodes (MELAS) and Fanconi’s syndrome. Pediatr Neurol. 1995, 13: 69-72. 10.1016/0887-8994(95)00082-Q.CrossRefPubMed Campos Y, Garcia-Silva T, Barrionuevo CR, Cabello A, Muley R, Arenas J: Mitochondrial DNA deletion in a patient with mitochondrial myopathy, lactic acidosis, and stroke-like episodes (MELAS) and Fanconi’s syndrome. Pediatr Neurol. 1995, 13: 69-72. 10.1016/0887-8994(95)00082-Q.CrossRefPubMed
10.
go back to reference Izzedine H, Launay-Vacher V, Isnard-Bagnis C, Deray G: Drug-induced Fanconi’s syndrome. Am J Kidney Dis. 2003, 41: 292-309. 10.1053/ajkd.2003.50037.CrossRefPubMed Izzedine H, Launay-Vacher V, Isnard-Bagnis C, Deray G: Drug-induced Fanconi’s syndrome. Am J Kidney Dis. 2003, 41: 292-309. 10.1053/ajkd.2003.50037.CrossRefPubMed
11.
go back to reference Evans CP, Winn WC: Extrathoracic localization of Legionella pneumophila in Legionnaires’ pneumonia. Am J Clin Pathol. 1981, 76: 813-815.CrossRefPubMed Evans CP, Winn WC: Extrathoracic localization of Legionella pneumophila in Legionnaires’ pneumonia. Am J Clin Pathol. 1981, 76: 813-815.CrossRefPubMed
12.
go back to reference Zhang C, Kuspa A: Transcriptional down-regulation and rRNA cleavage in Dictyostelium discoideum mitochondria during Legionella pneumophila infection. PLoS One. 2009, 4: e5706-10.1371/journal.pone.0005706.CrossRefPubMedPubMedCentral Zhang C, Kuspa A: Transcriptional down-regulation and rRNA cleavage in Dictyostelium discoideum mitochondria during Legionella pneumophila infection. PLoS One. 2009, 4: e5706-10.1371/journal.pone.0005706.CrossRefPubMedPubMedCentral
13.
go back to reference Chong A, Lima CA, Allan DS, Nasrallah GK, Garduno RA: The purified and recombinant Legionella pneumophila chaperonin alters mitochondrial trafficking and microfilament organization. Infect Immun. 2009, 77: 4724-4739. 10.1128/IAI.00150-09.CrossRefPubMedPubMedCentral Chong A, Lima CA, Allan DS, Nasrallah GK, Garduno RA: The purified and recombinant Legionella pneumophila chaperonin alters mitochondrial trafficking and microfilament organization. Infect Immun. 2009, 77: 4724-4739. 10.1128/IAI.00150-09.CrossRefPubMedPubMedCentral
14.
go back to reference Nishitarumizu K, Tokuda Y, Uehara H, Taira M, Taira K: Tubulointerstitial nephritis associated with Legionnaires’ disease. Intern Med. 2000, 39: 150-153. 10.2169/internalmedicine.39.150.CrossRefPubMed Nishitarumizu K, Tokuda Y, Uehara H, Taira M, Taira K: Tubulointerstitial nephritis associated with Legionnaires’ disease. Intern Med. 2000, 39: 150-153. 10.2169/internalmedicine.39.150.CrossRefPubMed
Metadata
Title
Acquired Fanconi syndrome in patients with Legionella pneumonia
Authors
Naoko Kinoshita-Katahashi
Hirotaka Fukasawa
Sayaka Ishigaki
Shinsuke Isobe
Shiro Imokawa
Yoshihide Fujigaki
Ryuichi Furuya
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2013
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/1471-2369-14-171

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