[A case of osteomalacia related to adefovir in a patient with chronic hepatitis B].
Adefovir dipivoxil, an acyclic nucleoside analogue, has been approved for the treatment of patients with chronic hepatitis B. This agent is efficacious particularly in those who have developed lamivudine resistance. The report according to hypophosphatemia induced by low dose adefovir therapy is very rare. We report one case in which osteomalacia with hypophosphatemia developed in a patient with chronic hepatitis B on adefovir dipivoxil at a low dose, 10 mg daily. A 66-year-old man, who had been taking adefovir for more than 4 years due to lamivudine resistance, presented with muscle weakness and bone pain in both thighs. After 3 years of adefovir therapy, hypophosphatemia and elevated serum alkaline phosphatase levels had been noted. A bone scan showed multiple hot uptakes. All the image findings and clinical symptoms, such as bone pain and muscle weakness were improved after correcting the hypophosphatemia with oral phosphorous supplementation.
Kwon
So Young
SY
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea. sykwonmd@hotmail.com
Ahn
Su Young
SY
Ko
Soon Young
SY
Jang
Yun Mi
YM
Choi
Yong Hoon
YH
Kim
Byung Kook
BK
Choe
Won Hyeok
WH
Lee
Chang Hong
CH
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004279:DNA, Viral / Q000097:blood; D019587:Dietary Supplements; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D017674:Hypophosphatemia / Q000139:chemically induced* / Q000150:complications; D008103:Liver Cirrhosis / Q000175:diagnosis; D008297:Male; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D010018:Osteomalacia / Q000175:diagnosis* / Q000209:etiology; D010710:Phosphates / Q000097:blood; D051598:Whole Body Imaging
D000998:Antiviral Agents; D004279:DNA, Viral; D063065:Organophosphonates; D010710:Phosphates; D000469:Alkaline Phosphatase; D000225:Adenine; C106812:adefovir dipivoxil