Sun Xiao-fang, Zhang Hua-bing, Li Xin-ping, Xia Wei-bo, Xing Xiao-ping, Meng Xun-wu
Department of Endocrinology, Chinese Academy of Medical Sciences, Beijing, China.
Zhonghua Nei Ke Za Zhi. 2011 Sep;50(9):754-7.
To investigate the clinical features and treatment protocol and prognosis for the hypophosphataemic osteomalacia related to adefovir dipivoxil.
Analysis was made upon a case of patient with chronic hepatitis B developed hypophosphataemic osteomalacia after administration of adefovir dipivoxil. Literature review was carried out to survey the global prevalence of hypophosphataemic osteomalacia after administration of adefovir dipivoxil among patients with chronic hepatitis B.
The clinical symptoms started paralleling to the time taking adefovir dipivoxil, and alleviated after the patient withdrawn adefovir dipivoxil 10 weeks and was given phosphorus. Meanwhile, serum inorganic phosphorus recovered to normal (0.98 mmol/L), which lowest level was 0.77 mmol/L. Systematic review of the literature showed that hyperphosphaturia related to adefovir dipivoxil was dose-dependent, time-dependent and reversible. All reported cases of hypophosphataemic osteomalacia secondary to adefovir dipivoxil (10 mg/d) were from Asian population.
Adefovir dipivoxil induced hypophosphataemic osteomalacia is rarely seen in clinical practice. Those patients with chronic hepatitis B who take adefovir dipivoxil, no matter dosages, should take periodical examinations including blood calcium and serum inorganic phosphorus to monitor whether hypophosphataemic osteomalacia occurs. Other anti-virus drugs could be used when it happens.
探讨与阿德福韦酯相关的低磷性骨软化症的临床特征、治疗方案及预后。
对1例慢性乙型肝炎患者服用阿德福韦酯后发生低磷性骨软化症的病例进行分析。进行文献综述，以调查慢性乙型肝炎患者服用阿德福韦酯后低磷性骨软化症的全球患病率。
临床症状与服用阿德福韦酯的时间平行出现，患者停用阿德福韦酯10周并补充磷后症状缓解。同时，血清无机磷恢复正常（0.98 mmol/L），最低水平为0.77 mmol/L。文献系统评价显示，与阿德福韦酯相关的高磷尿症具有剂量依赖性、时间依赖性且可逆。所有报道的继发于阿德福韦酯（10 mg/d）的低磷性骨软化症病例均来自亚洲人群。
阿德福韦酯所致低磷性骨软化症在临床实践中较为少见。服用阿德福韦酯的慢性乙型肝炎患者，无论剂量如何，均应定期进行包括血钙和血清无机磷在内的检查，以监测是否发生低磷性骨软化症。发生时可换用其他抗病毒药物。
