Fanconi′s syndrome induced by adefovir dipivoxil
10.3760/cma.j.issn.1008-5734.2018.02.011
- VernacularTitle:阿德福韦酯致范可尼综合征
- Author:
Yu SONG
1
;
Ya LU
1
;
Xueqin YANG
1
;
Xuan KANG
1
;
Qi WANG
1
;
Huiqin SHEN
1
Author Information
1. 山西医科大学第二临床医学院消化内科,太原,030001
- Publication Type:Journal Article
- Keywords:
Nucleotides;
Fanconi Syndrome;
Hepatitis B
- From:
Adverse Drug Reactions Journal
2018;20(2):140-141
- CountryChina
- Language:Chinese
-
Abstract:
A 50-year-old female patient with hepatitis B cirrhosis received oral lamivudine(100 mg/d) 8 years ago. Lamivudine resistance appeared one year after the administration. Then adefovir dipivoxil 10 mg/d was added. About 6 years after the combined antiviral treatments,weakness of lower limbs appeared and gradually worsened. At following one year,the patient successively presented with right hypochondrium pain accompanied by difficulty in turning over,limited movement of the lower extremities, and left hypochondrium pain. Laboratory tests showed serum phosphorus 0.55 mmol/L,serum calcium 2.13 mmol/L,and serum uric acid 98 mol/L. Fanconi syndrome(FS)was considered. Adefovir dipivoxil and lamivudine were discontinued and changed to tenofovir disoproxil(300 mg every other day). After one month of treatment,laboratory tests showed serum phosphorus 0.65 mmol/L,serum calcium 2.25 mmol/L, serum uric acid 109 mol/L,urine pH 6.00,24 hours urine potassium 69 mmol/L,urine sodium 384 mmol/L, and urine chlorine 350 mmol/L. Bone mineral density examination showed osteoporosis. Adefovir dipivoxil-related FS was diagnosed and calcitriol(0.25 g/d)was added. Three months later,weakness of bilateral lower extremities was improved markedly. Tenofovir disoproxil was discontinued and changed to entecavir (0.5 mg/d). Six months after discontinuation of adefovir dipivoxil,weakness of bilateral lower extremities subsided,right hypochondrium pain alleviated,and moderate physical activity could be tolerated,serum phosphorus,calcium,and uric acid levels returned to normal,and urine electrolyte output was obviously reduced.
