Fanconi syndrome and lactic acidosis associated with stavudine and lamivudine therapy.
We report a case of the nucleoside reverse transcriptase inhibitors, stavudine and lamivudine inducing Fanconi syndrome in a patient. The presence of simultaneous lactic acidosis suggests mitochondrial toxicity within the proximal renal tubular cells as the likely pathogenesis. We recommend that both the above nucleosides be added to the list of antiretroviral drugs that can induce Fanconi syndrome and that patients on stavudine and lamivudine be monitored carefully for early signs of Fanconi syndrome.
Nelson
Mark
M
Imperial College, Department of HIV Medicine, Chelsea and Westminster Hospital, London, UK.
Azwa
Alex
A
Sokwala
Ahmed
A
Harania
Reena Shah
RS
Stebbing
Justin
J
D000140:Acidosis, Lactic / Q000139:chemically induced*; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects*; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D005198:Fanconi Syndrome / Q000139:chemically induced*; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D019259:Lamivudine / Q000009:adverse effects*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D018119:Stavudine / Q000009:adverse effects*
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine; D018119:Stavudine