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KMID : 0882420100780020261
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Korean Journal of Medicine
2010 Volume.78 No. 2 p.261 ~ p.265
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A case of hypophosphatemic osteomalacia associated with low-dose adefovir dipivoxil treatment
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Yoo Ki-Deok
Jeong Jong-Heon
Cho Soo-Kyung
Kim Gheun-Ho
Choi Ho-Soon
Kim Dong-Sun
Jun Jae-Bum
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Abstract
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Adefovir dipivoxil (ADV) effectively inhibits lamivudine-resistant hepatitis B virus replication. Hypophosphatemia and elevated serum creatinine are ADV-related nephrotoxicity caused by high-dose ADV. Hypophosphatemic osteomalacia is very rare and is induced by low-dose ADV. A 61-year-old man suffering from chronic hepatitis B manifested with generalized myalgia and bone pain, especially in both ankles and knees. He had been administered ADV for 56 months, since lamivudine-resistant HBV was detected. He developed severe hypophosphatemia and elevated serum alkaline phosphatase levels with a high bone fraction. Bone densitometry and a whole-body bone scan revealed osteoporosis and multiple hot uptake lesions. Blood chemistry and clinical symptoms improved after discontinuing the ADV.
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KEYWORD
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Adefovir dipivoxil, Nephrotoxicity, Hypophosphatemia, Osteomalacia
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