Fanconi syndrome induced by adefovir dipivoxil: a case report and clinical review

Abstract

More than 150 cases of Fanconi syndrome (FS) or hypophosphatemia osteomalacia induced by low-dose adefovir dipivoxil (ADV) have been reported since 2002, when ADV was introduced for the long-term treatment of hepatitis B virus (HBV) infection. Because the life expectancy of HBV-infected individuals has increased, the adverse effects of long-term treatment with antiviral therapies are increasingly observed, and nephrotoxicity is one of the most severe adverse effects of ADV. Therefore, the number of cases may be far higher than reported. Moreover, ADV-induced FS is often misdiagnosed or diagnosed long after it first develops. ADV-induced FS may seriously decrease patient quality of life and lead to bone fractures and even disability. Although progress has been made in the identification of biomarkers and treatments, few systematic clinical guidelines or clinical reviews for FS induced by ADV have been reported. In this study, we highlighted the recent progress toward understanding of FS induced by ADV, described a clinical case, and summarized the primary characteristics and laboratory findings of this disease.

Fanconi syndrome induced by the long-term use of tenofovir disoproxil fumarate: a case report and literature review

“… 1 The features of FS include glycosuria, aminoaciduria, hypercalciuria, renal sodium loss, hypophosphatemia, hypouricemia, proximal renal tubular acidosis, and proteinuria in the renal tubules; and related symptoms, such as muscle weakness, flaccid paralysis, periodic paralysis, and tetany. 2 FS is typically acquired in adulthood, and adult FS can be caused by systemic disease, drugs, and other factors. The systemic diseases that cause FS include amyloidosis, multiple myeloma/light chain disease, paroxysmal nocturnal hemoglobinuria, kidney transplantation, tubulointerstitial nephritis, and membranous nephropathy with anti-tubular basement membrane antibodies.…”