What is the role of heavy metal exposure in Fanconi syndrome?

Updated: Feb 09, 2018
  • Author: Sahar Fathallah-Shaykh, MD; Chief Editor: Craig B Langman, MD  more...
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Answer

A multitude of toxic and immunologic factors can impair proximal tubule function, resulting in a Fanconi syndrome. Prominent among these factors is exposure to heavy metals, such as cadmium, lead, mercury, platinum, and uranium. Rarely, Chinese herbs have been reported to cause Fanconi syndrome. Lead intoxication is the only heavy metal exposure that is encountered in children. However, in children, the tubular dysfunction is usually eclipsed by manifestations related to the central nervous system, such as apathy, somnolence, irritability, aggressiveness, and poor coordination. A history of pica can usually be elicited from the parents. An accurate, early diagnosis depends on laboratory determinations of lead levels. Treatment with chelating agents is usually effective in reversing the neurologic and renal abnormalities.


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