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Peer-reviewedCC BY 4.0Kidney Medicine

Topiramate-Induced Fanconi Syndrome: A Case Report

  • Daniela Berlinkova1
  • Ria Rohatgi2
  • Rajeev Rohatgi3,4
  • Angela Z. Jiatu1
4 affiliations
  1. 1Department of Pharmacy, James J. Peters VAMC, Bronx, NY
  2. 2Harborfields High School, NY
  3. 3Icahn School of Medicine at Mount Sinai, NY
  4. 4Department of Medicine, James J. Peters VAMC, Bronx, NY
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Abstract

Topiramate (TPM), originally approved in 1996 for epilepsy, is now widely administered to prevent migraines, induce weight loss, and suppress alcohol cravings. Common renal adverse side effects include metabolic acidosis and nephrolithiasis; however, acute kidney injury (AKI) is uncommon or underreported. In this report, we present a case of a 41-year-old man with a history of hypertension, obesity, tonic-clonic seizures, and migraines who developed AKI associated with Fanconi syndrome while administered TPM 100 mg daily for migraine prevention. The Naranjo Adverse Drug Reaction Probability Scale, a measure of the likelihood that a drug is causing an adverse reaction, indicated that TPM probably (score of 8) caused AKI with Fanconi syndrome. After supportive therapy and drug cessation the patient’s kidney function normalized and the Fanconi syndrome resolved. This case is important for several reasons: (1) this is the third case of AKI and second case associated with Fanconi syndrome, which implies a relationship with TPM, (2) the cases illustrate that early recognition and discontinuation of TPM resolves AKI, and (3) common elements between the cases relay plausible risk factors. Thus, clinicians who prescribe TPM should consider monitoring patients for AKI and electrolyte abnormalities.

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Cite

BibTeXRIS
BibTeX
@article{berlinkova2026topiramateinduced,
  title = {{Topiramate-Induced Fanconi Syndrome: A Case Report}},
  author = {Daniela Berlinkova and Ria Rohatgi and Rajeev Rohatgi and Angela Z. Jiatu},
  journal = {Kidney Medicine},
  year = {2026},
  month = sep,
  doi = {10.1016/j.xkme.2026.101522},
  url = {https://doi.org/10.1016/j.xkme.2026.101522},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Topiramate-Induced Fanconi Syndrome: A Case Report
AU  - Daniela Berlinkova
AU  - Ria Rohatgi
AU  - Rajeev Rohatgi
AU  - Angela Z. Jiatu
PY  - 2026
DA  - 2026/09/09
JO  - Kidney Medicine
DO  - 10.1016/j.xkme.2026.101522
UR  - https://doi.org/10.1016/j.xkme.2026.101522
AB  - Topiramate (TPM), originally approved in 1996 for epilepsy, is now widely administered to prevent migraines, induce weight loss, and suppress alcohol cravings. Common renal adverse side effects include metabolic acidosis and nephrolithiasis; however, acute kidney injury (AKI) is uncommon or underreported. In this report, we present a case of a 41-year-old man with a history of hypertension, obesity, tonic-clonic seizures, and migraines who developed AKI associated with Fanconi syndrome while administered TPM 100 mg daily for migraine prevention. The Naranjo Adverse Drug Reaction Probability Scale, a measure of the likelihood that a drug is causing an adverse reaction, indicated that TPM probably (score of 8) caused AKI with Fanconi syndrome. After supportive therapy and drug cessation the patient’s kidney function normalized and the Fanconi syndrome resolved. This case is important for several reasons: (1) this is the third case of AKI and second case associated with Fanconi syndrome, which implies a relationship with TPM, (2) the cases illustrate that early recognition and discontinuation of TPM resolves AKI, and (3) common elements between the cases relay plausible risk factors. Thus, clinicians who prescribe TPM should consider monitoring patients for AKI and electrolyte abnormalities.
SN  - 2590-0595
ER  -