Fanconi Syndrome Associated with Long-term Adefovir and Subsequent Tenofovir Therapy for Chronic Hepatitis B Infection.
10.3904/kjm.2016.91.2.174
- Author:
Hyun Woo LEE
1
;
June Sung LEE
;
Se Won OH
;
Joo Hyuk JUNG
;
Min Yong PARK
;
Kyung Ah KIM
;
Yeon Han SONG
Author Information
1. Department of Internal Medicine, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Adefovir;
Tenofovir;
Fanconi syndrome
- MeSH:
Ankle;
Coinfection;
Fanconi Syndrome*;
Female;
Glucose;
Glycosuria;
Hepatitis B, Chronic*;
Hepatitis, Chronic*;
HIV;
Humans;
Hypocalcemia;
Hypokalemia;
Hypophosphatemia;
Kidney Tubules, Proximal;
Lower Extremity;
Middle Aged;
Proteinuria;
Sensation;
Uric Acid
- From:Korean Journal of Medicine
2016;91(2):174-178
- CountryRepublic of Korea
- Language:English
-
Abstract:
Adefovir dipivoxil (ADV) and tenofovir disoproxil fumarate (TDF) are nucleotide analogues used to treat chronic hepatitis B (CHB) infection. Nephrotoxicity associated with the use of these medications causes Fanconi syndrome, a rare condition involving generalized dysfunction of the proximal renal tubule causing impaired reabsorption of glucose, uric acid, and phosphate. Fanconi syndrome has been previously reported in patients with human immunodeficiency virus (HIV) or HIV-CHB coinfection treated with other antiretroviral therapies. However, it is rarely reported in patients with CHB monoinfection. We observed a case of Fanconi syndrome in a 61-year-old woman with CHB monoinfection and a history of long-term ADV therapy (42 months), followed by TDF treatment for 9 months. She presented with ankle pain and a tingling sensation in both lower extremities. Laboratory tests revealed hypokalemia, hypocalcemia, hypophosphatemia, hypouricemia, proteinuria, and glycosuria. This case illustrates the importance of recognizing Fanconi syndrome associated with nucleotide analogue treatment and the need to carefully observe symptoms and monitor renal function in these patients.
