Acquired Fanconi syndrome in patients with Legionella pneumonia

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

doi:10.1186/1471-2369-14-171

Naoko Kinoshita-Katahashi, Hirotaka Fukasawa + Show 5 more

Open Access

https://doi.org/10.1186/1471-2369-14-171

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Abstract

BackgroundHyponatremia is often observed in patients with Legionella pneumonia. However, other electrolyte abnormalities are uncommon and the mechanism remains to be clarified.Case presentationWe 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.ConclusionTo the best of our knowledge, this is the first report demonstrating Fanconi syndrome associated with Legionella pneumonia.

Highlights

Hyponatremia is often observed in patients with Legionella pneumonia
We present extremely rare cases of Legionella pneumonia complicated by Fanconi syndrome
Because the electrolyte abnormalities disappeared after treatment for Legionella pneumonia and there was no evidence of other causes of Fanconi syndrome, it is most likely that Fanconi syndrome was associated with Legionella pneumonia in our cases

Summary

Introduction

Hyponatremia is often observed in patients with Legionella pneumonia. 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. Conclusion: To the best of our knowledge, this is the first report demonstrating Fanconi syndrome associated with Legionella pneumonia. We present extremely rare cases of Legionella pneumonia complicated by Fanconi syndrome. His renal function was normal and the arterial blood gases analysis showed mild metabolic acidosis (Table 1).

Results

Conclusion