Obstructive jaundice secondary to pancreatic cancer associated with partial Fanconi-like syndrome: A case report

Abstract

Severe cholestasis may induce renal tubular injury via bile pigment toxicity, leading to bile cast nephropathy (BCN) or, rarely, a Fanconi-like syndrome. We report the case of an 87-year-old man with pancreatic adenocarcinoma and profound hyperbilirubinemia who developed partial proximal tubular dysfunction, characterized by hypouricemia, hypophosphatemia, and hyperchloremic metabolic acidosis, without glucosuria or bicarbonaturia. Fractional excretion studies confirmed proximal tubulopathy. This case represents, to our knowledge, the first description of Fanconi-like syndrome secondary to obstructive jaundice in pancreatic cancer, highlighting the importance of screening for tubular dysfunction in cholestatic states.