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Acquired Fanconi syndrome associated with prolonged adefovir dipivoxil therapy in a chronic hepatitis B patient.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Law, Siu-Tong Li, Kin Kong Ho, Yiu Yan
Description	Country affiliation: Hong Kong Author Affiliation: Law ST ( 1Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong)
Abstract	Adefovir dipivoxil (ADV) is one of the commonly used antiviral agents in the treatment of chronic hepatitis B infection. Nephrotoxicity is dose related and occurred at a daily dosage of >30 mg. However, it is now increasingly recognized that nephrotoxicity can occur at a daily dose of 10 mg. We present a case of acquired Fanconi syndrome in a patient with chronic hepatitis B who had been treated with ADV for 4 years. She presented with progressive muscle weakness and generalized bone pain. The laboratory results showed the feature of proximal renal tubule dysfunction, particularly severe hypophosphatemia. Diagnostic approach to hypophosphatemia and proximal renal tubular dysfunction is discussed. After switching over from ADV to entecavir, her symptoms and laboratory findings returned to normal. Acquired Fanconi syndrome can be associated with ADV at a conventional dosage, and therefore, patients treated with long-term ADV should have regular monitoring of renal function and calcium and phosphate levels.
File Format	HTM / HTML
ISSN	10752765
Issue Number	6
Volume Number	20
e-ISSN	15363686
Journal	American Journal of Therapeutics
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2013-11-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Adenine Analogs & Derivatives Antiviral Agents Adverse Effects Fanconi Syndrome Chemically Induced Hepatitis B, Chronic Drug Therapy Organophosphonates Administration & Dosage Therapeutic Use Aged Calcium Metabolism Drug Monitoring Methods Diagnosis Physiopathology Female Humans Hypophosphatemia Time Factors Case Reports Journal Article
Content Type	Text
Resource Type	Case study Article
Subject	Pharmacology Pharmacology (medical)

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