Adefovir-induced Fanconi syndrome associated with osteomalacia
Fanconi syndrome is a dysfunction of the proximal renal tubules that results in impaired reabsorption and increased urinary loss of phosphate and other solutes. The pathophysiology of drug-induced Fanconi syndrome is unclear. Here we report the case of a 36-year-old woman who presented with pain in...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of the Liver
2018-09-01
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| Series: | Clinical and Molecular Hepatology |
| Subjects: | |
| Online Access: | http://e-cmh.org/upload/pdf/cmh-2017-0009.pdf |
| _version_ | 1818025524149092352 |
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| author | Samel Park Woo-Il Kim Dai-Hyun Cho Yeo-Joo Kim Hong-Soo Kim Ji-Hee Kim Seung-Kuy Cha Kyu-Sang Park Ji-Hye Lee Sang Mi Lee Eun Young Lee |
| author_facet | Samel Park Woo-Il Kim Dai-Hyun Cho Yeo-Joo Kim Hong-Soo Kim Ji-Hee Kim Seung-Kuy Cha Kyu-Sang Park Ji-Hye Lee Sang Mi Lee Eun Young Lee |
| author_sort | Samel Park |
| collection | DOAJ |
| description | Fanconi syndrome is a dysfunction of the proximal renal tubules that results in impaired reabsorption and increased urinary loss of phosphate and other solutes. The pathophysiology of drug-induced Fanconi syndrome is unclear. Here we report the case of a 36-year-old woman who presented with pain in multiple bones and proteinuria. She had a 7-year history of taking adefovir at 10 mg/day for chronic hepatitis B. Three years previously she had received surgery for a nontraumatic right femur neck fracture, after which she continued to complain of pain in multiple bones, and proteinuria, glycosuria, and phosphaturia were noted. The findings of a light-microscope examination of a renal biopsy sample were normal, but mitochondrial damage of the proximal tubules was evident in electron microscopy. Western blot analysis revealed that the level of serum fibroblast growth factor 23 (FGF23) was lower than in normal controls. After 2 months of treatment, hypophosphatemia and proximal tubular dysfunction were reversed, and serum FGF23 had normalized. This case suggests that direct mitochondrial damage in proximal tubules can cause drug-induced Fanconi syndrome associated with osteomalacia. |
| first_indexed | 2024-12-10T04:17:28Z |
| format | Article |
| id | doaj.art-d68f87b0062d4e90855c26cfd8df8896 |
| institution | Directory Open Access Journal |
| issn | 2287-2728 2287-285X |
| language | English |
| last_indexed | 2024-12-10T04:17:28Z |
| publishDate | 2018-09-01 |
| publisher | Korean Association for the Study of the Liver |
| record_format | Article |
| series | Clinical and Molecular Hepatology |
| spelling | doaj.art-d68f87b0062d4e90855c26cfd8df88962022-12-22T02:02:33ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2018-09-0124333934410.3350/cmh.2017.00091372Adefovir-induced Fanconi syndrome associated with osteomalaciaSamel Park0Woo-Il Kim1Dai-Hyun Cho2Yeo-Joo Kim3Hong-Soo Kim4Ji-Hee Kim5Seung-Kuy Cha6Kyu-Sang Park7Ji-Hye Lee8Sang Mi Lee9Eun Young Lee10 Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Physiology, Yonsei University Wonju College of Medicine, Wonju, Korea Department of Pathology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, KoreaFanconi syndrome is a dysfunction of the proximal renal tubules that results in impaired reabsorption and increased urinary loss of phosphate and other solutes. The pathophysiology of drug-induced Fanconi syndrome is unclear. Here we report the case of a 36-year-old woman who presented with pain in multiple bones and proteinuria. She had a 7-year history of taking adefovir at 10 mg/day for chronic hepatitis B. Three years previously she had received surgery for a nontraumatic right femur neck fracture, after which she continued to complain of pain in multiple bones, and proteinuria, glycosuria, and phosphaturia were noted. The findings of a light-microscope examination of a renal biopsy sample were normal, but mitochondrial damage of the proximal tubules was evident in electron microscopy. Western blot analysis revealed that the level of serum fibroblast growth factor 23 (FGF23) was lower than in normal controls. After 2 months of treatment, hypophosphatemia and proximal tubular dysfunction were reversed, and serum FGF23 had normalized. This case suggests that direct mitochondrial damage in proximal tubules can cause drug-induced Fanconi syndrome associated with osteomalacia.http://e-cmh.org/upload/pdf/cmh-2017-0009.pdfAdefovirFanconi syndromeMitochondriaProximal tubulesOsteomalacia |
| spellingShingle | Samel Park Woo-Il Kim Dai-Hyun Cho Yeo-Joo Kim Hong-Soo Kim Ji-Hee Kim Seung-Kuy Cha Kyu-Sang Park Ji-Hye Lee Sang Mi Lee Eun Young Lee Adefovir-induced Fanconi syndrome associated with osteomalacia Clinical and Molecular Hepatology Adefovir Fanconi syndrome Mitochondria Proximal tubules Osteomalacia |
| title | Adefovir-induced Fanconi syndrome associated with osteomalacia |
| title_full | Adefovir-induced Fanconi syndrome associated with osteomalacia |
| title_fullStr | Adefovir-induced Fanconi syndrome associated with osteomalacia |
| title_full_unstemmed | Adefovir-induced Fanconi syndrome associated with osteomalacia |
| title_short | Adefovir-induced Fanconi syndrome associated with osteomalacia |
| title_sort | adefovir induced fanconi syndrome associated with osteomalacia |
| topic | Adefovir Fanconi syndrome Mitochondria Proximal tubules Osteomalacia |
| url | http://e-cmh.org/upload/pdf/cmh-2017-0009.pdf |
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