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Korean J Hepatol. 2008;14(3):381-386. Published online September 30, 2008.
DOI: https://doi.org/10.3350/kjhep.2008.14.3.381
- A case of severe hypophosphatemia related to adefovir dipivoxil treatment in a patient with Liver cirrhosis related to hepatitis B virus
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- Abstract
- Adefovir dipivoxyl (ADV) effectively suppresses hepatitis B virus (HBV) replication but exhibits nephrotoxicity
with severe hypophosphatemia when administered at a high dosage. This is the first report of severe
hypophosphatemic osteomalacia induced by ADV at 10 mg/day. A 42-year-old man with HBV-related chronic
liver disease presented with generalized bone pain, especially in the left ankle. He had been taking ADV for
more than 1.5 years following a clinical breakthrough due to lamivudine-resistant HBV. Aggravating severe
hypophosphatemia and elevated serum alkaline phosphatase levels with high bone fraction had been noted after
6 months of ADV therapy. Bone densitometry, simple bone X-rays, and a whole-body bone scan demonstrated
osteoporosis and multiple areas with hot uptake, especially in the left ankle. All the image findings and
symptoms improved after correcting the hypophosphatemia. (Korean J Hepatol 2008;14:381-386)
Keywords :Adefovir; Hypophosphatemia; Osteomalacia
