Fanconi Syndrome Due to Tenofovir Disoproxil Fumarate in a Patient with Chronic Hepatitis B Induced Cirrhosis: A Case Report
Tenofovir Disoproxil Fumarate-Induced Fanconi Syndrome in Chronic Hepatitis B Induced Cirrhosis
Abstract
We present a 63-year-old woman with chronic hepatitis B. The patient has a history of cirrhosis due to chronic hepatitis B and is under treatment with Tenofovir disoproxil fumarate. The patient presented to our center with nausea, vomiting, and severe metabolic acidosis. After initial evaluation, along with the typical course of events
and the exclusion of differential diagnoses of normal anion gap metabolic acidosis, we determined that the cause of illness was related to Tenofovir disoproxil fumarate. All our practical and laboratory data supported a diagnosis of proximal tubular acidosis. After discontinuing the drug for two weeks and providing supportive management, metabolic acidosis and electrolyte imbalance improved. The other isoform of Tenofovir
(Tenofovir alafenamide) was initiated for the patient, and after two months of followup, there were no signs of acidosis or electrolyte imbalance.
[2] Stinco M, Rubino C, Trapani S, Indolfi G. Treatment of hepatitis B virus infection in children and adolescents. World
J Gastroenterol. 2021 Sep 28;27(36):6053-63. https://doi. org/10.3748/wjg.v27.i36.6053
[3] Maldonado JE, Velosa JA, Kyle RA, Wagoner RD, Holley KE, Salassa RM. Fanconi syndrome in adults. A manifestation of a latent form of myeloma. Am J Med. 1975 Mar;58(3):354-64. https://doi.org/10.1016/0002-9343(75)90601-4
[4] Leboulleux M, Lelongt B, Mougenot B, Touchard G, Makdassi R, Rocca A, et al. Protease resistance and binding of Ig light chains in myeloma-associated tubulopathies. Kidney Int. 1995 Jul;48(1):72-9. https://doi.org/10.1038/ki.1995.269
[5] Messiaen T, Deret S, Mougenot B, Bridoux F, Dequiedt P, Dion JJ, et al. Adult Fanconi syndrome secondary to light
chain gammopathy. Clinicopathologic heterogeneity and unusual features in 11 patients. Medicine (Baltimore). 2000
May;79(3):135-54. https://doi.org/10.1097/00005792- 200005000-00002
[6] Mirza N, Marson AG, Pirmohamed M. Effect of topiramate on acid-base balance: extent, mechanism and effects. Br J Clin Pharmacol. 2009 Nov;68(5):655-61. https://doi.org/10.1111/ j.1365-2125.2009.03521.x
[7] Gupta SK. Tenofovir-associated Fanconi syndrome: review of the FDA adverse event reporting system. AIDS Patient
Care STDS. 2008 Feb;22(2):99-103. https://doi.org/10.1089/ apc.2007.0052
[8] Shi M, Chen L. Sjögren’s syndrome complicated with Fanconi syndrome and Hashimoto’s thyroiditis: Case report and literature review. J Int Med Res. 2016 Jun;44(3):753-9. https://doi. org/10.1177/0300060515593767
[9] Ram R, Swarnalatha G, Dakshinamurty KV. Renal tubular acidosis in Sjögren’s syndrome: a case series. Am J Nephrol.
2014;40(2):123-30. https://doi.org/10.1159/000365199
| Files | ||
| Issue | Vol 9 No 2 (2024): March-April | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v9i2.16927 | |
| Keywords | ||
| Renal tubular acidosis Tenofovir disoproxil fumarate Tenofovir alafenamide Hepatitis B Cirrhosis | ||
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