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KMID : 1103920080140030381
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Korean Journal of Hepatology
2008 Volume.14 No. 3 p.381 ~ p.386
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A case of severe hypophosphatemia related to adefovir dipivoxil treatment in a patient with Liver cirrhosis related to hepatitis B virus
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Lee Hyun-Ju
Kim Tae-Nyeun
Eun Jong-Ryul
Choi Jae-Won
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Abstract
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Adefovir dipivoxyl (ADV) effectively suppresses hepatitis B virus (HBV) replication but exhibits nephrotoxicity with severe hypophosphatemia when administered at a high dosage. This is the first report of severe hypophosphatemic osteomalacia induced by ADV at 10 mg/day. A 42-year-old man with HBV-related chronic liver disease presented with generalized bone pain, especially in the left ankle. He had been taking ADV for more than 1.5 years following a clinical breakthrough due to lamivudine-resistant HBV. Aggravating severe hypophosphatemia and elevated serum alkaline phosphatase levels with high bone fraction had been noted after 6 months of ADV therapy. Bone densitometry, simple bone X-rays, and a whole-body bone scan demonstrated osteoporosis and multiple areas with hot uptake, especially in the left ankle. All the image findings and symptoms improved after correcting the hypophosphatemia.
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KEYWORD
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Adefovir, Hypophosphatemia, Osteomalacia
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