Journal of Clinical & Experimental Nephrology

Fanconi Syndrome Associated with the use of Tenofovir Treatment in a Patient with Hepatitis B Virus Infection: Reporting a Case

Fanconi syndrome is a rare disorder of the functioning of the renal tubules that results in the excretion of excessive amounts of glucose, bicarbonate, phosphates (phosphorus salts), uric acid, potassium and certain amino acids in the urine, which it can be caused by multiple pathologies, both hereditary and acquired, including those associated with pharmacological nephrotoxicity. Tenofovir Disoproxil Fumarate (TDF) is a nucleotide analogue reverse transcriptase inhibitor used for the treatment of Hepatitis B Virus (HBV) infection, similar in structure to Adefovir and Cidofovir. We present the case of a 63-year-old woman with known HBV infection for 22 years, receiving treatment with Tenofovir. In outpatient check-ups, he reported a progressive picture of asthenia and diffuse bone pain. In several determinations an elevation of alkaline phosphatase and Parathyroid Hormone (PTH) had been observed, in addition to analytical data among which were marked glycosuria, hypophosphatemia and hyperphosphaturia, tubular acidosis with normal GAP anion, hypokalemia and hyperkaliuria, hypouricaemia and hyperuricosuria and subacute deterioration of renal function. All abnormalities resolved after discontinuation of TDF and initiation of treatment for the aforementioned abnormalities, illustrating the importance of clinicians considering the possibility of TDF proximal tubulopathy in patients presenting with clinical manifestations such as polyuria, polydipsia, bone pain, constipation, general syndrome or mineral metabolism abnormalities.

Author(s): Alejandro Jose Rosales Montero

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