A case of severe hypophosphatemia related to adefovir dipivoxil treatment in a patient with liver cirrhosis related to hepatitis B virus.
10.3350/kjhep.2008.14.3.381
- Author:
Heon Ju LEE
1
;
Jae Won CHOI
;
Tae Nyeun KIM
;
Jong Ryul EUN
Author Information
1. Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea. hjlee@med.yu.ac.kr
- Publication Type:Case Reports ; English Abstract
- Keywords:
Adefovir;
Hypophosphatemia;
Osteomalacia
- MeSH:
Absorptiometry, Photon;
Adenine/administration & dosage/adverse effects/*analogs & derivatives;
Adult;
Antiviral Agents/administration & dosage/*adverse effects;
Bone Density;
DNA, Viral/analysis;
Drug Resistance, Viral;
Hepatitis B virus/drug effects;
Hepatitis B, Chronic/complications/*drug therapy/virology;
Humans;
Hypophosphatemia/*chemically induced;
Lamivudine/therapeutic use;
Liver Cirrhosis/*virology;
Male;
Phosphonic Acids/administration & dosage/*adverse effects;
Tomography, X-Ray Computed
- From:The Korean Journal of Hepatology
2008;14(3):381-386
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Adefovir dipivoxyl (ADV) effectively suppresses hepatitis B virus (HBV) replication but exhibits nephrotoxicity with severe hypophosphatemia when administered at a high dosage. This is the first report of severe hypophosphatemic osteomalacia induced by ADV at 10 mg/day. A 42-year-old man with HBV-related chronic liver disease presented with generalized bone pain, especially in the left ankle. He had been taking ADV for more than 1.5 years following a clinical breakthrough due to lamivudine-resistant HBV. Aggravating severe hypophosphatemia and elevated serum alkaline phosphatase levels with high bone fraction had been noted after 6 months of ADV therapy. Bone densitometry, simple bone X-rays, and a whole-body bone scan demonstrated osteoporosis and multiple areas with hot uptake, especially in the left ankle. All the image findings and symptoms improved after correcting the hypophosphatemia.
