同时使用 HIV 暴露前预防药物和他克莫司导致的范可尼综合征。
Fanconi Syndrome Induced by Concomitant HIV PrEP and Tacrolimus.
机构信息
University of Wyoming, Laramie, USA.
University of Utah Health, Salt Lake City, USA.
出版信息
J Investig Med High Impact Case Rep. 2021 Jan-Dec;9:23247096211050207. doi: 10.1177/23247096211050207.
Fanconi syndrome (FS) is a severe grade of drug-induced proximal tubule toxicity. There are numerous causes for acquired FS, and drug toxicity is one of the most common. FS is known to be associated with the nucleoside reverse transcriptase inhibitor (NRTI) tenofovir disoproxil fumarate (TDF). TDF is often used in combination with emtricitabine (FTC) for preexposure prophylaxis (PrEP) of human immunodeficiency virus (HIV) infection. TDF/FTC-induced FS has been observed as a dose-related phenomenon that is directly correlated to kidney function, high levels of absorption of the drug into the proximal tubule, and interactions with other medications. This case report describes a patient who acquired FS after starting TDF/FTC for PrEP in the setting of chronic kidney disease (CKD) with concomitant tacrolimus therapy, a known nephrotoxic agent.
范可尼综合征（FS）是一种严重的药物诱导近端肾小管毒性。获得性 FS 有许多原因，药物毒性是最常见的原因之一。FS 与核苷逆转录酶抑制剂（NRTI）替诺福韦二吡呋酯（TDF）有关。TDF 常与恩曲他滨（FTC）联合用于人类免疫缺陷病毒（HIV）感染的暴露前预防（PrEP）。已经观察到 TDF/FTC 诱导的 FS 是一种剂量相关的现象，与肾功能、药物在近端肾小管中的高吸收水平以及与其他药物的相互作用直接相关。本病例报告描述了一名慢性肾脏病（CKD）患者在接受他克莫司治疗的同时开始 TDF/FTC 进行 PrEP 后出现 FS 的情况，他克莫司是一种已知的肾毒性药物。
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