Urinary β-2 Microglobulin Levels Sensitively Altered in an Osteomalacia Patient Receiving Add-on Adefovir Dipivoxil Therapy for Hepatitis B Virus Infection.
Adefovir dipivoxil (ADV) is effective for hepatitis B virus (HBV) infection; however, ADV may provoke renal injury resulting in osteomalacia, and this side effect is seldom recognized until bone fractures emerge. We herein present a 66-year-old woman with HBV infection who received ADV for 6 years. Although she exhibited no sign of bone fractures, her urinary β-2 microglobulin (β2MG) level increased to 83,837 μg/L and scintigraphy revealed minimal fractures of the third rib. ADV was subsequently reduced and her urinary β2MG rapidly fell to 3,637 μg/L. Conversely, her urinary N-acetyl-β-D-glucosaminidase, and serum phosphate, alkaline phosphatase levels did not respond.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Aichi Medical University, School of Medicine, Japan.
Junko
J
Takagi
Hiroyuki
H
Morita
Kiyoaki
K
Ito
Tomohiko
T
Ohashi
Sho
S
Hirase
Tatsuo
T
Ito
Takkan
T
Morishima
Kazuo
K
Otake
Masashi
M
Yoneda
D000225:Adenine / Q000009:adverse effects / Q000031:analogs & derivatives*; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D005260:Female; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D007564:Japan; D063065:Organophosphonates / Q000009:adverse effects*; D010018:Osteomalacia / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy*; D001613:beta 2-Microglobulin / Q000652:urine*
D000998:Antiviral Agents; D063065:Organophosphonates; D001613:beta 2-Microglobulin; D000225:Adenine; C106812:adefovir dipivoxil