END-STAGE RENAL INTERSTITIAL FIBROSIS IN AN ADULT 10 YEARS AFTER IFOSFAMIDE THERAPY

A 33-year-old male presented with end-stage renal failure. Renal biops y showed severe interstitial fibrosis without glomerulopathy or vascul opathy. More than 10 years previously the patient had been successfull y treated for recurrent rhabdomyosarcoma. The treatment included ifosf amide, a drug known to cause acute tubular dysfunction, Though a possi ble synergistic effect of previous radiation which was well within acc epted tolerance limits cannot be excluded, it would appear that ifosfa mide was almost certainly the major cause of the late onset chronic re nal disease.