| A case of severe hypophosphatemia related to adefovir dipivoxil treatment in a patient with Liver cirrhosis related to hepatitis B virus |
| Heon Ju Lee , Tae Nyeun Kim , Jong Ryul Eun , Jae Won Choi |
| Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea |
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| ABSTRACT |
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Adefovir dipivoxyl (ADV) effectively suppresses hepatitis B virus (HBV) replication but exhibits nephrotoxicity
with severe hypophosphatemia when administered at a high dosage. This is the first report of severe
hypophosphatemic osteomalacia induced by ADV at 10 mg/day. A 42-year-old man with HBV-related chronic
liver disease presented with generalized bone pain, especially in the left ankle. He had been taking ADV for
more than 1.5 years following a clinical breakthrough due to lamivudine-resistant HBV. Aggravating severe
hypophosphatemia and elevated serum alkaline phosphatase levels with high bone fraction had been noted after
6 months of ADV therapy. Bone densitometry, simple bone X-rays, and a whole-body bone scan demonstrated
osteoporosis and multiple areas with hot uptake, especially in the left ankle. All the image findings and
symptoms improved after correcting the hypophosphatemia. (Korean J Hepatol 2008;14:381-386) |
| KeyWords:
Adefovir; Hypophosphatemia; Osteomalacia |
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