Bone scintigraphy and secondary osteomalacia due to nephrotoxicity in a chronic hepatitis B patient treated with tenofovir.
Tenofovir is a nucleotide analogue used for the treatment of chronic hepatitis B and HIV infection. The safety of tenofovir is high but it has been described that tenofovir produces tubular toxicity and Fanconi's syndrome in some HIV-infected patients. To our knowledge this is the first documented case of bone involvement in Fanconi's syndrome in a patient treated with tenofovir for chronic hepatitis B without HIV coinfection. Bone scintigraphy has proven to be very useful for the diagnosis of secondary osteomalacia. Normalization of the bone scan after the withdrawal of the drug and the decline in alkaline phosphatase and phosphate serum levels reinforce the cause-effect relationship.
Servicio de Medicina Nuclear y Unidad de Hepatología, Hospital Carlos III, Centro de Investigación Biomédica en Red de Enfermedades y Digestivas (CIBERehd), Madrid, Spain. Electronic address: marivalgomez@gmail.com.
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Gómez Martinez
Servicio de Medicina Nuclear y Unidad de Hepatología, Hospital Carlos III, Centro de Investigación Biomédica en Red de Enfermedades y Digestivas (CIBERehd), Madrid, Spain.
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Gallardo
Servicio de Medicina Nuclear y Unidad de Hepatología, Hospital Carlos III, Centro de Investigación Biomédica en Red de Enfermedades y Digestivas (CIBERehd), Madrid, Spain.
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Pirogova
Servicio de Medicina Nuclear y Unidad de Hepatología, Hospital Carlos III, Centro de Investigación Biomédica en Red de Enfermedades y Digestivas (CIBERehd), Madrid, Spain.
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García-Samaniego
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D001842:Bone and Bones / Q000000981:diagnostic imaging*; D005198:Fanconi Syndrome / Q000139:chemically induced*; D005260:Female; D019694:Hepatitis B, Chronic / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D010018:Osteomalacia / Q000139:chemically induced* / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000068698:Tenofovir
D063065:Organophosphonates; D018894:Reverse Transcriptase Inhibitors; D000068698:Tenofovir; D000225:Adenine
Bone scintigraphy; Gammagrafía ósea; Hepatitis B; Osteomalacia; Tenofovir