title: Pathologic Femoral Neck Fracture Due to Fanconi Syndrome Induced by Adefovir Dipivoxil Therapy for Hepatitis B.
abstract: In Fanconi syndrome, hypophosphatemic osteomalacia is caused by proximal renal tubule dysfunction which leads to impaired reabsorption of amino acids, glucose, urate, and phosphate. We present a rare case of a 43-year-old Korean male who was found to have insufficiency stress fracture of the femoral neck secondary to osteomalacia due to Fanconi syndrome. He had been receiving low-dose adefovir dipivoxil (ADV, 10 mg/day) for the treatment of chronic hepatitis B virus infection for 7 years and he subsequently developed severe hypophosphatemia and proximal renal tubule dysfunction. The incomplete femoral neck fracture was fixed with multiple cannulated screws to prevent further displacement of the initial fracture. After cessation of ADV and correction of hypophosphatemia with oral phosphorus supplementation, the patient's clinical symptoms, such as bone pain, muscle weakness, and laboratory findings improved.
authors.affiliation: Department of Orthopaedic Surgery, CHA Gumi Medical Center, CHA University, Gumi, Korea.
authors.forename: Yoon-Suk
authors.initials: YS
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, CHA Gumi Medical Center, CHA University, Gumi, Korea.
authors.forename: Byung-Kook
authors.initials: BK
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, CHA Gumi Medical Center, CHA University, Gumi, Korea.
authors.forename: Ho-Jae
authors.initials: HJ
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, CHA Gumi Medical Center, CHA University, Gumi, Korea.
authors.forename: Jinmyoung
authors.initials: J
authors.lastname: Dan
mesh_terms: D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D005198:Fanconi Syndrome / Q000139:chemically induced / Q000150:complications; D005265:Femoral Neck Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D019694:Hepatitis B, Chronic / Q000188:drug therapy*; D006801:Humans; D008297:Male; D063065:Organophosphonates / Q000009:adverse effects* / Q000627:therapeutic use; D010018:Osteomalacia / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000628:therapy
chemical_list: D000998:Antiviral Agents; D063065:Organophosphonates; D000225:Adenine; C106812:adefovir dipivoxil
keywords: Adefovir dipivoxil; Chronic hepatitis B; Fanconi syndrome; Osteomalacia; Spontaneous fractures