A Case of Tenofovir-associated Fanconi Syndrome in Patient with Chronic Hepatitis B

Dongwoo Kim; Jongjin Lee; Dae-ha Kim; Kyuho Kang; Sang Jun Suh; Young Kul Jung; Hyung Joon Yim

doi:10.4166/kjg.2016.68.6.317

Journal List > Korean J Gastroenterol > v.68(6) > 1007591

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Kim, Lee, Kim, Kang, Suh, Jung, and Yim: A Case of Tenofovir-associated Fanconi Syndrome in Patient with Chronic Hepatitis B

Case Report

Korean J Gastroenterol 2016;68(6):317-320.

Published online: 4 October 2016

DOI: https://doi.org/10.4166/kjg.2016.68.6.317

A Case of Tenofovir-associated Fanconi Syndrome in Patient with Chronic Hepatitis B

Dongwoo Kim, Jongjin Lee, Dae-ha Kim, Kyuho Kang, Sang Jun Suh, Young Kul Jung, Hyung Joon Yim

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea

Correspondence to: Young Kul Jung, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan 15355, Korea. Tel: +82-31-412-7623, Fax: +82-31-412-5582, E-mail: 93cool@hanmail.net

Received 21 July 2016 Revised 4 October 2016 Accepted 12 October 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tenofovir disoproxil fumarate (TDF) is one of the most widely used treatment options for human immunodeficiency virus (HIV) and HBV infections. Despite its efficacy and safety, some cases of nephrotoxicity have been reported in the treatment of HIV patients. Even more recently, very few cases of Fanconi syndrome associated with tenofovir therapy in HBV monoinfection have been reported. Herein, we report a case of a 47-year-old male with an HBV monoinfection, who developed Fanconi syndrome and a secondary osteomalacia with multiple bone pain. After TDF withdrawal and supplementation of calcitriol, his renal function was reverted. Although the overall risk of TDF-associated nephrotoxicity is very low, both glomerular and tubular function should be monitored in patients undergoing TDF treatment.

Keywords: Tenofovir, Hepatitis B virus, Fanconi syndrome, Kidney tubules, proximal, Osteomalacia

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Fig. 1.

Serum creatinine levels before and after cessation of tenofovir disoproxil fumarate.

Fig. 2.

Serum phosphorus levels before and after cessation of tenofovir disoproxil fumarate.

Fig. 3.

Bone scan. Multiple active bone lesions in thoracic-lumbar-sacral spines (T5, L5), right scapula, both ribs (right 2nd, 4th, 12th and left 1st, 6th, 7th ribs), and both iliac bones.

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