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KMID : 1188320100040030389
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Gut and Liver
2010 Volume.4 No. 3 p.389 ~ p.393
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Fanconi’s Syndrome Associated with Prolonged Adefovir Dipivoxil Therapy in a Hepatitis B Virus Patient
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Jung Young-Kul
Yeon Jong-Eun
Choi Jong-Hwan
Kim Chung-Ho
Jung Eun-Suk
Kim Ji-Hoon
Park Jong-Jae
Kim Jae-Seon
Park Young-Tae
Byun Kwan-Soo
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Abstract
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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.
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KEYWORD
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Fanconi syndrome, Adefovir, Chronic hepatitis B
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