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Fanconi syndrome induced by long-term therapy with adefovir dipivoxil:report of two cases

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Author:: No author available

Journal Title:: Chinese Journal of Clinical Infectious Diseases

Issue:: 6

DOI:: 10.3760/cma.j.issn.1674-2397.2013.06.012

Key Word:: 肝炎,乙型;范可尼综合征;阿德福韦酯;Hepatitis B;Fanconi syndrome;Adefovir dipivoxil

Abstract：例1 患者男,63岁,因腰痛、双下肢乏力5个月于2012年7月来我院就诊.HBV血清学标志物阳性7年,2007年被诊断为乙型肝炎肝硬化代偿期,予拉米夫定(LAM,100 mg/d)抗病毒治疗,2009年因YMDD变异改为LAM联合阿德福韦酯(ADV,10 mg/d)治疗.2011年8月血清肌酐(Cr)轻度升高,尿蛋白(+).5个月前出现腰部疼痛,双下肢乏力,呈逐渐加重.入院时体格检查:慢性肝病面容,巩膜无黄染,无肝掌,蜘蛛痣(+).腹部平软,肝脾肋缘下未及,移动性浊音阴性.双上肢肌力正常,双下肢肌力Ⅳ级,肌张力正常.实验室检查:血常规正常;HBV血清学标志物:HBsAg(+),HBeAg(+),抗-HBc(+);HBV DNA载量低于检测值下限;肝功能:丙氨酸转氨酶(ALT) 54 U/L,天冬氨酸转氨酶(AST)26 U/L,谷酰转肽酶(GGT)62 U/L,碱性磷酸酶(ALP) 367 U/L,其余指标正常;肾功能:血Cr137.8 μmol/L;电解质:P-0.5 mmol/L,K+3.4 mmol/L,Cl-110.6 mmol/L,其余正常.空腹血糖正常.甲状旁腺激素:1 pmol/L(1.3～9.3 pmol/L).血25-羟维生素D3正常.

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