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KMID : 1207720160080020232
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Clinics in Orthopedic Surgery
2016 Volume.8 No. 2 p.232 ~ p.236
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Pathologic Femoral Neck Fracture Due to Fanconi Syndrome Induced by Adefovir Dipivoxil Therapy for Hepatitis B
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Lee Yoon-Suk
Kim Byung-Kook
Lee Ho-Jae
Dan Jin-Myoung
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Abstract
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In Fanconi syndrome, hypophosphatemic osteomalacia is caused by proximal renal tubule dysfunction which leads to impaired reabsorption of amino acids, glucose, urate, and phosphate. We present a rare case of a 43-year-old Korean male who was found to have insufficiency stress fracture of the femoral neck secondary to osteomalacia due to Fanconi syndrome. He had been receiving low-dose adefovir dipivoxil (ADV, 10 mg/day) for the treatment of chronic hepatitis B virus infection for 7 years and he subsequently developed severe hypophosphatemia and proximal renal tubule dysfunction. The incomplete femoral neck fracture was fixed with multiple cannulated screws to prevent further displacement of the initial fracture. After cessation of ADV and correction of hypophosphatemia with oral phosphorus supplementation, the patient's clinical symptoms, such as bone pain, muscle weakness, and laboratory findings improved.
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KEYWORD
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Chronic hepatitis B, Adefovir dipivoxil, Fanconi syndrome, Osteomalacia, Spontaneous fractures
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