Gut Liver.  2010 Sep;4(3):389-393.

Fanconi's Syndrome Associated with Prolonged Adefovir Dipivoxil Therapy in a Hepatitis B Virus Patient

• Jung YK
• Yeon JE
• Choi JH
• Kim CH
• Jung ES
• Kim JH
• Park JJ
• Kim JS
• Bak YT
• Byun KS

Abstract

Adefovir dipivoxil (ADV) is commonly used as an antiviral agent in the treatment of chronic hepatitis B or human immunodeficiency virus infection. Nephrotoxicity has been shown to occur at daily dosages of 60-120 mg. Fanconi's syndrome is a generalized dysfunction of the renal proximal tubular cells, which is usually accompanied by complications. Here we report a case of Fanconi's syndrome in a chronic hepatitis B patient who had been treated with a prolonged regimen of ADV at 10 mg/day. A 47-year-old man complained of severe back and chest-wall pain. He had chronic hepatitis B and had been treated with ADV at a daily dose of 10 mg for 38 months. He was hospitalized because of severe bone pain, and laboratory and radiologic findings suggested a diagnosis of Fanconi's syndrome with osteomalacia. After discontinuation of the ADV, he recovered and was discharged from hospital. His laboratory findings had normalized within 2 weeks. This case indicates that Fanconi's syndrome can be acquired by a chronic hepatitis B patient taking ADV at a conventional dosage of 10 mg/day. Therefore, patients treated with long-term ADV should be checked regularly for the occurrence of ADV-induced Fanconi's syndrome.

Keyword

Fanconi syndrome; Adefovir; Chronic hepatitis B

MeSH Terms

Adenine
Fanconi Syndrome
Hepatitis
Hepatitis B
Hepatitis B virus
Hepatitis B, Chronic
HIV
Humans
Middle Aged
Organophosphonates
Osteomalacia
Adenine
Organophosphonates