A case of hypophosphatemic osteomalacia associated with low-dose adefovir dipivoxil treatment / 대한내과학회지

ABSTRACT

Adefovir dipivoxil (ADV) effectively inhibits lamivudine-resistant hepatitis B virus replication. Hypophosphatemia and elevated serum creatinine are ADV-related nephrotoxicity caused by high-dose ADV. Hypophosphatemic osteomalacia is very rare and is induced by low-dose ADV. A 61-year-old man suffering from chronic hepatitis B manifested with generalized myalgia and bone pain, especially in both ankles and knees. He had been administered ADV for 56 months, since lamivudine-resistant HBV was detected. He developed severe hypophosphatemia and elevated serum alkaline phosphatase levels with a high bone fraction. Bone densitometry and a whole-body bone scan revealed osteoporosis and multiple hot uptake lesions. Blood chemistry and clinical symptoms improved after discontinuing the ADV.