title: Long-term observation of osteomalacia caused by adefovir-induced Fanconi's syndrome.
abstract: A 64-year-old man suffering polyarthralgia and bone pain was referred to our hospital. Renal dysfunction, hypophosphatemia and increased levels of bone alkaline phosphatase were found. The patient's serum creatinine level had gradually increased after the initiation of adefovir dipivoxil administration for hepatitis B. In agreement with multifocal uptakes of bone scintigraphy, iliac bone biopsy revealed an abnormal increase in osteoid tissues. Reducing the dose of adefovir and initiating the administration of eldecalcitol were effective for reducing proteinuria and glucosuria, and for ameliorating bone pain with an increase in serum phosphate level. This case first showed a clinical course of hypophosphatemic osteomalacia caused by secondary Fanconi's syndrome for 8 years after adefovir administration. Early diagnosis is important for the reversibility of bone damage and for a better renal prognosis.
authors.affiliation: Department of General Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Terasaka
authors.forename: Eijiro
authors.initials: E
authors.lastname: Ueta
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Ebara
authors.forename: Koichi
authors.initials: K
authors.lastname: Waseda
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Hanayama
authors.forename: Akinobu
authors.initials: A
authors.lastname: Takaki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kawabata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sugiyama
authors.forename: Ko
authors.initials: K
authors.lastname: Hidani
authors.forename: Fumio
authors.initials: F
authors.lastname: Otsuka
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives*; D000998:Antiviral Agents / Q000009:adverse effects*; D005198:Fanconi Syndrome / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000009:adverse effects*; D010018:Osteomalacia / Q000209:etiology*
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; C053001:adefovir; D000225:Adenine