Korean J Med.
2010 Feb;78(2):261-265.
A case of hypophosphatemic osteomalacia associated with low-dose adefovir dipivoxil treatment
- Affiliations
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- 1Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
- 2Department of Nephrology, Hanyang University College of Medicine, Seoul, Korea.
- 3Department of Gastroenterology, Hanyang University College of Medicine, Seoul, Korea.
- 4Department of Endocrinology, Hanyang University College of Medicine, Seoul, Korea.
- 5Department of Hospital for Rheumatic Diseases, Hanyang University College of Medicine, Seoul, Korea. junjb@hanyang.ac.kr
Abstract
- Adefovir dipivoxil (ADV) effectively inhibits lamivudine-resistant hepatitis B virus replication. Hypophosphatemia and elevated serum creatinine are ADV-related nephrotoxicity caused by high-dose ADV. Hypophosphatemic osteomalacia is very rare and is induced by low-dose ADV. A 61-year-old man suffering from chronic hepatitis B manifested with generalized myalgia and bone pain, especially in both ankles and knees. He had been administered ADV for 56 months, since lamivudine-resistant HBV was detected. He developed severe hypophosphatemia and elevated serum alkaline phosphatase levels with a high bone fraction. Bone densitometry and a whole-body bone scan revealed osteoporosis and multiple hot uptake lesions. Blood chemistry and clinical symptoms improved after discontinuing the ADV.
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