Two Cases of Hypophosphatemic Osteomalacia After Long-term Low Dose Adefovir Therapy in Chronic Hepatitis B and Literature Review
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초록
Adefovir dipivoxil (ADV) is a nucleotide used as long-term therapy of chronic hepatitis B. Many published reports have shown that long-term high-dose therapy with adefovircan be associated with proximal renal tubular dysfunction resulting in significant hypo-phosphatemia, renal insufficiency and osteomalacia. We have encountered two patientswho developed evidence of hypophosphatemic osteomalacia while on long-term low-dose adefovir therapy for chronic hepatitis B. We report on its clinical features and its po-tential resolution with cessation of the drug and supplementation with phosphate. Wealso reviewed the other published cases associated with hypophosphatemic osteomala-cia after low-dose adefovir therapy. The symptoms and the hypophosphatemia im-proved after cessation of the drug and supplementation with phosphate in most cases. Patients taking adefovir long-term should receive regular investigation of the phosphatelevel and renal function.
Abstract
Adefovir dipivoxil (ADV) is a nucleotide used as long-term therapy of chronic hepatitis B. Many published reports have shown that long-term high-dose therapy with adefovircan be associated with proximal renal tubular dysfunction resulting in significant hypo-phosphatemia, renal insufficiency and osteomalacia. We have encountered two patientswho developed evidence of hypophosphatemic osteomalacia while on long-term low-dose adefovir therapy for chronic hepatitis B. We report on its clinical features and its po-tential resolution with cessation of the drug and supplementation with phosphate. Wealso reviewed the other published cases associated with hypophosphatemic osteomala-cia after low-dose adefovir therapy. The symptoms and the hypophosphatemia im-proved after cessation of the drug and supplementation with phosphate in most cases. Patients taking adefovir long-term should receive regular investigation of the phosphatelevel and renal function.
참고문헌 (25)
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