THE DEVELOPMENT OF RICKETS AS A COMPLICATION OF CHEMOTHERAPY FOR THE TREATMENT OF WILMS-TUMOR

Musculoskeletal complaints were the presenting symptoms in four of 44 children (9%) treated for relapsed Wilms' tumors with ifosfamide, a de rivative of cyclophosphamide. Subsequent radiologic examination reveal ed rachitic bone and joint changes, A fifth child manifested clinical and radiographic signs of rickets after presenting with hypophosphatem ia, hypouricemia, and glycosuria, Recognition of a potential drug-indu ced Fanconi syndrome is important when managing pediatric oncology pat ients previously treated with ifosfamide, Early replacement therapy is recommended when proximal renal tubular abnormalities are detected to help prevent and control the severe metabolic bone disease associated with the Fanconi syndrome.