Abstract：
Although some dietary supplements have been reported to cause renal dysfunction, there have been few reports of supplement-induced Fanconi syndrome. We present the case of a 56-year-old woman with Fanconi syndrome that developed after she consumed a red yeast rice supplement. She was referred to our hospital because of renal dysfunction, and was found to have electrolyte abnormalities, including hypophosphatemia and hypouricemia, renal diabetes, and hyperchloremic metabolic acidosis, and was, therefore, diagnosed with Fanconi syndrome. Renal biopsy revealed proximal tubular injury characterized by severely degenerated tubular epithelial cells as well as mild hypocellular fibrosis. We speculated that the red yeast rice supplement, which the patient had been consuming for approximately 1 year, might be a cause of her syndrome, because reports of renal dysfunction associated with the consumption of red yeast rice supplements have emerged in Japan since 2024. After the supplement was discontinued and oral prednisolone treatment was initiated, the patient\'s renal function improved and her electrolyte abnormalities were ameliorated. Furthermore, even after tapering off and discontinuing the prednisolone over approximately 12 weeks, her renal function remained. Because Fanconi syndrome may be caused by various exogenous substances, the taking of a thorough medical history is crucial, including with respect to the use not only of prescription medications, but also other substances, including supplements.
摘要：
虽然一些膳食补充剂被报道会导致肾功能不全，关于补充剂诱导的Fanconi综合征的报道很少。我们介绍了一名56岁的Fanconi综合征妇女，该妇女在食用红曲米补充剂后发展。她因为肾功能不全被转诊到我们医院,被发现有电解质异常，包括低磷酸盐血症和低尿酸血症,肾性糖尿病,和高氯血症代谢性酸中毒，而且是，因此,被诊断为Fanconi综合征.肾活检显示近端肾小管损伤，其特征是肾小管上皮细胞严重变性以及轻度细胞纤维化。我们推测红曲米补充剂，患者已经食用了大约1年，可能是她综合症的原因,因为自2024年以来，日本出现了与食用红曲米补充剂相关的肾功能不全的报道。停止补充并开始口服泼尼松龙治疗后，患者肾功能改善，电解质异常改善。此外，即使在大约12周内逐渐减少并停用泼尼松龙，她的肾功能仍然存在。因为范可尼综合征可能是由各种外源性物质引起的,全面的病史至关重要，包括不仅使用处方药，还有其他物质，包括补品。
