title: Fanconi's Syndrome Associated with Prolonged Adefovir Dipivoxil Therapy in a Hepatitis B Virus Patient.
abstract: Adefovir dipivoxil (ADV) is commonly used as an antiviral agent in the treatment of chronic hepatitis B or human immunodeficiency virus infection. Nephrotoxicity has been shown to occur at daily dosages of 60-120 mg. Fanconi's syndrome is a generalized dysfunction of the renal proximal tubular cells, which is usually accompanied by complications. Here we report a case of Fanconi's syndrome in a chronic hepatitis B patient who had been treated with a prolonged regimen of ADV at 10 mg/day. A 47-year-old man complained of severe back and chest-wall pain. He had chronic hepatitis B and had been treated with ADV at a daily dose of 10 mg for 38 months. He was hospitalized because of severe bone pain, and laboratory and radiologic findings suggested a diagnosis of Fanconi's syndrome with osteomalacia. After discontinuation of the ADV, he recovered and was discharged from hospital. His laboratory findings had normalized within 2 weeks. This case indicates that Fanconi's syndrome can be acquired by a chronic hepatitis B patient taking ADV at a conventional dosage of 10 mg/day. Therefore, patients treated with long-term ADV should be checked regularly for the occurrence of ADV-induced Fanconi's syndrome.
authors.affiliation: Department of Internal Medicine, Gachon University of Medicine and Science Gil Medical Center, Incheon, Korea.
authors.forename: Young Kul
authors.initials: YK
authors.lastname: Jung
authors.forename: Jong Eun
authors.initials: JE
authors.lastname: Yeon
authors.forename: Jong Hwan
authors.initials: JH
authors.lastname: Choi
authors.forename: Chung Ho
authors.initials: CH
authors.lastname: Kim
authors.forename: Eun Suk
authors.initials: ES
authors.lastname: Jung
authors.forename: Ji Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Jong Jae
authors.initials: JJ
authors.lastname: Park
authors.forename: Jae Seon
authors.initials: JS
authors.lastname: Kim
authors.forename: Young-Tae
authors.initials: YT
authors.lastname: Bak
authors.forename: Kwan Soo
authors.initials: KS
authors.lastname: Byun