Haverkort Milly E, van der Spek Bas W, Lips Paul, Slieker Walentina A, ter Heine Rob, Huitema Alwin D, Bronsveld Willem
Department of Internal Medicine, Sionsberg Hospital, Dokkum.
Scand J Infect Dis. 2011 Oct;43(10):821-6. doi: 10.3109/00365548.2011.577805. Epub 2011 May 12.
We present 2 human immunodeficiency virus-infected patients with tenofovir disoproxil fumarate-induced Fanconi syndrome, leading to osteomalacia. Intracellular tenofovir diphosphate levels were measured in 1 patient and were found to be very high, with plasma tenofovir levels just slightly elevated. Fibroblast growth factor-23, a phosphaturic hormone, was decreased in both patients and is therefore unlikely to have a pathophysiological role in this pathology. The different potential factors contributing to the development of tenofovir-related kidney proximal tubular dysfunction are discussed and the data presented may help to further elucidate its pathogenesis.
我们报告了2例感染人类免疫缺陷病毒的患者，他们因服用富马酸替诺福韦二吡呋酯而引发范科尼综合征，进而导致骨软化症。对其中1例患者的细胞内二磷酸替诺福韦水平进行了测量，发现其水平非常高，而血浆替诺福韦水平仅略有升高。成纤维细胞生长因子23是一种排磷激素，在这2例患者中均降低，因此不太可能在这种病理状况中发挥病理生理作用。我们讨论了导致替诺福韦相关近端肾小管功能障碍发生的不同潜在因素，所呈现的数据可能有助于进一步阐明其发病机制。
