Development of osteomalacia in a post-liver transplant patient receiving adefovir dipivoxil
Open Access
- 1 January 2010
- journal article
- Published by Baishideng Publishing Group Inc. in World Journal of Hepatology
- Vol. 2 (12) , 442-6
Abstract
We report the case of a patient treated with living donor-related liver transplantation who suffered from osteomalacia during adefovir dipivoxil (ADV)-containing antiviral therapy for lamivudine-resistant hepatitis B virus infection. The patient had generalized bone pain, with severe hypophosphatemia after 20 mo of ADV therapy. Radiographic studies demonstrated the presence of osteomalacia. The peak plasma ADV level was 38 ng/mL after administration of ADV at 10 mg/d. It was also found that ADV affected the metabolism of tacrolimus, a calcineurin-inhibitor, and caused an increase in the plasma levels of tacrolimus. The disability was reversed with the withdrawal of ADV and with mineral supplementation. ADV can cause an elevation of plasma tacrolimus levels, which may be associated with renal dysfunction. High levels of ADV and tacrolimus can cause nephrotoxicity and osteomalacia. This case highlights the importance of considering a diagnosis of osteomalacia in liver transplantation recipients treated with both ADV and tacrolimus.Keywords
This publication has 27 references indexed in Scilit:
- Living donor liver transplantation for hepatitis B cirrhosisJournal of Gastroenterology and Hepatology, 2007
- Posttransplantation chronic renal damage in nonrenal transplant recipientsKidney International, 2005
- A Dose-Ranging Study of the Efficacy and Tolerability of Entecavir in Lamivudine-Refractory Chronic Hepatitis B PatientsGastroenterology, 2005
- The development of hypophosphataemic osteomalacia with myopathy in two patients with HIV infection receiving tenofovir therapyHIV Medicine, 2005
- Acute renal failure and Fanconi syndrome in an AIDS patient on tenofovir treatment—case report and review of literatureJournal of Infection, 2005
- Adefovir Dipivoxil Therapy for Lamivudine–Resistant Hepatitis B in Pre- and Post-Liver Transplantation PatientsHepatology, 2003
- The Growing Problem of Chronic Renal Failure after Transplantation of a Nonrenal OrganNew England Journal of Medicine, 2003
- Selection of Mutations in the Hepatitis B Virus Polymerase During Therapy of Transplant Recipients With LamivudineHepatology, 1996
- Mutation in Hbv Rna–Dependent Dna Polymerase Confers Resistance to Lamivudine In VivoHepatology, 1996
- Mutation in HBV RNA-dependent DNA polymerase confers resistance to lamivudine in vivoHepatology, 1996