title: Tenofovir-induced Fanconi syndrome and osteomalacia in two HIV-infected patients: role of intracellular tenofovir diphosphate levels and review of the literature.
abstract: We present 2 human immunodeficiency virus-infected patients with tenofovir disoproxil fumarate-induced Fanconi syndrome, leading to osteomalacia. Intracellular tenofovir diphosphate levels were measured in 1 patient and were found to be very high, with plasma tenofovir levels just slightly elevated. Fibroblast growth factor-23, a phosphaturic hormone, was decreased in both patients and is therefore unlikely to have a pathophysiological role in this pathology. The different potential factors contributing to the development of tenofovir-related kidney proximal tubular dysfunction are discussed and the data presented may help to further elucidate its pathogenesis.
authors.affiliation: Department of Internal Medicine, Sionsberg Hospital, Dokkum. mehaverkort@hotmail.com
authors.forename: Milly E
authors.initials: ME
authors.lastname: Haverkort
authors.forename: Bas W
authors.initials: BW
authors.lastname: van der Spek
authors.forename: Paul
authors.initials: P
authors.lastname: Lips
authors.forename: Walentina A
authors.initials: WA
authors.lastname: Slieker
authors.forename: Rob
authors.initials: R
authors.lastname: ter Heine
authors.forename: Alwin D
authors.initials: AD
authors.lastname: Huitema
authors.forename: Willem
authors.initials: W
authors.lastname: Bronsveld
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D000328:Adult; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D011756:Diphosphates / Q000097:blood; D005198:Fanconi Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000821:virology; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use; D010018:Osteomalacia / Q000139:chemically induced* / Q000175:diagnosis / Q000821:virology; D011877:Radionuclide Imaging; D000068698:Tenofovir; D051598:Whole Body Imaging
chemical_list: D019380:Anti-HIV Agents; D011756:Diphosphates; D063065:Organophosphonates; D000068698:Tenofovir; D000225:Adenine