Fanconi syndrome complicated with spinal cord diseases and peripheral neuropathy related to adefovir dipivoxil
10.3760/cma.j.issn.1008-5734.2014.01.018
- VernacularTitle:阿德福韦酯相关范科尼综合征合并脊髓病及周围神经病
- Author:
Lu LI
1
;
Hongsong SONG
;
Haodong CAI
Author Information
1. 100191,北京大学第三医院感染疾病科
- Publication Type:Journal Article
- Keywords:
Adefovir dipivoxil;
Fanconi syndrome;
Spinal cord diseases;
Peripheral nervous system diseases
- From:
Adverse Drug Reactions Journal
2014;16(1):52-53
- CountryChina
- Language:Chinese
-
Abstract:
A 63-year-old man with hepatitis B and cirrhosis received oral adefovir dipivoxil 10 mg once daily.About three and a half years after the start of the drug therapy,the patient developed numbness and weakness of lower limbs.He experienced unstable walking in the forth years.Laboratory tests revealed a serum phosphate level of 0.37 mmol/L.Electromyogram showed deep sensory pathway conduction block of bilateral lower limbs.The spinal cord diseases complicated with peripheral neuropathy was considered.After treatment with vitamin B1 and B12,the patient improved.About two months later,the symptoms of lower limb numbness and weakness relapsed.Urinalysis showed alpha 1-microglobulin 257.8 mg/L,microalbumin 168 mg/L and N-acetyl beta-D-glucosaminidase 90 U/L.Bone mineral density examination revealed osteopenia.The patient was diagnosed with Fanconi syndrome related to adefovir dipivoxil.Adefovir dipivoxil was stopped and his therapy was switched to oral entecavir 0.5 mg once daily.At the same time,he was given multivitamin and minerals tablets and calcitriol.Eighteen days later,the serum phosphate level rose to 0.75 mmo[/L and the degrees of lower limb weakness relieved.Five months later,he walked normally.Repeat laboratory tests showed the following levels:urine alpha 1-microglobulin 32.8 mg/L,microalbumin 14 mg/L,N-acetyl beta-D-glucosaminidase 15 U/L,and serum phosphate 0.90 mmol/L.
