Kim Dongwoo, Lee Jongjin, Kim Dae Ha, Kang Kyuho, Suh Sang Jun, Jung Young Kul, Yim Hyung Joon
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.
Korean J Gastroenterol. 2016 Dec 25;68(6):317-320. doi: 10.4166/kjg.2016.68.6.317.
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.
富马酸替诺福韦二吡呋酯（TDF）是治疗人类免疫缺陷病毒（HIV）和乙肝病毒（HBV）感染最广泛使用的治疗选择之一。尽管其疗效和安全性良好，但在治疗HIV患者时已报告了一些肾毒性病例。更近一些时候，在单纯HBV感染中，与替诺福韦治疗相关的范科尼综合征病例报告极少。在此，我们报告一例47岁单纯HBV感染男性病例，该患者出现了范科尼综合征和继发性骨软化症，并伴有多处骨痛。停用TDF并补充骨化三醇后，其肾功能恢复。尽管与TDF相关的肾毒性总体风险非常低，但接受TDF治疗的患者应监测肾小球和肾小管功能。
