Song Kaixin, Yan Qi, Yang Yi, Lv Mengyue, Chen Yuting, Dai Yue, Zhang Le, Huang Yi, Zhang Cuntai, Gao Hongyu
Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Int Med Res. 2020 Oct;48(10):300060520954713. doi: 10.1177/0300060520954713.
More than 150 cases of Fanconi syndrome (FS) or hypophosphatemia osteomalacia induced by low-dose adefovir dipivoxil (ADV) have been reported since 2002, when ADV was introduced for the long-term treatment of hepatitis B virus (HBV) infection. Because the life expectancy of HBV-infected individuals has increased, the adverse effects of long-term treatment with antiviral therapies are increasingly observed, and nephrotoxicity is one of the most severe adverse effects of ADV. Therefore, the number of cases may be far higher than reported. Moreover, ADV-induced FS is often misdiagnosed or diagnosed long after it first develops. ADV-induced FS may seriously decrease patient quality of life and lead to bone fractures and even disability. Although progress has been made in the identification of biomarkers and treatments, few systematic clinical guidelines or clinical reviews for FS induced by ADV have been reported. In this study, we highlighted the recent progress toward understanding of FS induced by ADV, described a clinical case, and summarized the primary characteristics and laboratory findings of this disease.
自2002年低剂量阿德福韦酯（ADV）被用于长期治疗乙型肝炎病毒（HBV）感染以来，已报告了150多例由其引起的范科尼综合征（FS）或低磷血症性骨软化症。由于HBV感染者的预期寿命有所增加，抗病毒治疗长期使用的不良反应日益受到关注，而肾毒性是ADV最严重的不良反应之一。因此，实际病例数可能远高于报告数量。此外，ADV诱导的FS常常被误诊，或者在首次发病很久之后才被诊断出来。ADV诱导的FS可能会严重降低患者的生活质量，导致骨折甚至残疾。尽管在生物标志物识别和治疗方面已取得进展，但针对ADV诱导的FS的系统性临床指南或临床综述鲜有报道。在本研究中，我们着重介绍了在理解ADV诱导的FS方面的最新进展，描述了一个临床病例，并总结了该疾病的主要特征和实验室检查结果。
