38. Tenofovir-associated Fanconi syndrome and severe anemia in a patient with chronic hepatitis B monoinfection: A case report
Main Article Content
Abstract
Tenofovir disoproxil fumarate (TDF) is considered as a safe drug, used in the treatment of HIV and chronic hepatitis B. However, this drug has also been reported to have adverse effects on kidney function in a few cases. We report a case of Fanconi syndrome in a patient with chronic hepatitis B, due to a life-threatening side effect of TDF, after 5 years of treatment. The diagnosis of Fanconi syndrome is based on histopathological results and recovery of kidney function after interventional treatment. Our report warned physicians about rare and serious side effects for timely management when using TDF in the treatment of chronic hepatitis B. In addition, we also discussed risk factors for TDF-related nephrotoxicity and provided recommendations for monitoring renal function during TDF treatment.
Article Details
Keywords
Fanconi syndrome, Tenofovir disoproxil fumarate
References
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22. Hwang HS, Park CW, Song MJ. Tenofovir-associated Fanconi syndrome and nephrotic syndrome in a patient with chronic hepatitis B monoinfection. Hepatology. 2015;62(4):1318-1320. doi:10.1002/hep.27730
23. Buldukoglu OC, Akın M. Tenofovir Disoproxil Fumarate as a Possible Agent of Drug-Induced Anemia in a Liver Transplant Patient. Akd Tıp D. 2021;7(1):158-160. Accessed May 12, 2024. https://dergipark.org.tr/tr/pub/akd/issue/67029/1047396
24. Baranek B, Wang S, Cheung AM, et al. The effect of tenofovir disoproxil fumarate on bone mineral density: a systematic review and meta-analysis. Antivir Ther. 2020;25(1):21-32. doi:10.3851/IMP3346
25. Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560-1599. doi:10.1002/hep.29800
2. Pereira PCB, Miranda DM, Oliveira EA, et al. Molecular Pathophysiology of Renal Tubular Acidosis. Curr Genomics. 2009;10(1):51-59. doi:10.2174/138920209787581262
3. Laing CM, Toye AM, Capasso G, et al. Renal tubular acidosis: developments in our understanding of the molecular basis. Int J Biochem Cell Biol. 2005;37(6):1151-1161. doi:10.1016/j.biocel.2005.01.002
4. Gupta S, Gao JJ, Emmett M, et al. Topiramate and metabolic acidosis: an evolving story. Hosp Pract (1995). 2017;45(5):192-195. doi:10.1080/21548331.2017.1370969
5. Fung HB, Stone EA, Piacenti FJ. Tenofovir disoproxil fumarate: a nucleotide reverse transcriptase inhibitor for the treatment of HIV infection. Clin Ther. 2002;24(10):1515-1548. doi:10.1016/s0149-2918(02)80058-3
6. Herlitz LC, Mohan S, Stokes MB, et al. Tenofovir nephrotoxicity: acute tubular necrosis with distinctive clinical, pathological, and mitochondrial abnormalities. Kidney Int. 2010;78(11):1171-1177. doi:10.1038/ki.2010.318
7. Iwata K, Nagata M, Watanabe S, et al. Distal renal tubular acidosis without renal impairment after use of tenofovir: a case report. BMC Pharmacol Toxicol. 2016;17:52. doi:10.1186/s40360-016-0100-y
8. Simon M, Meah A. Tenofovir as a Cause of Acquired Fanconi’s Syndrome. Ann Afr Med. 2023;22(1):128-130. doi:10.4103/aam.aam_198_21
9. Cho H, Cho Y, Cho EJ, et al. Tenofovir-associated nephrotoxicity in patients with chronic hepatitis B: two cases. Clin Mol Hepatol. 2016;22(2):286-291. doi:10.3350/cmh.2015.0066
10. Liatsou E, Tatouli I, Mpozikas A, et al. Tenofovir-Induced Fanconi Syndrome Presenting with Life-Threatening Hypokalemia: Review of the Literature and Recommendations for Early Detection. Journal of Clinical Medicine. 2023;12(22):7178. doi:10.3390/jcm12227178
11. Coca S, Perazella MA. Rapid communication: acute renal failure associated with tenofovir: evidence of drug-induced nephrotoxicity. Am J Med Sci. 2002;324(6):342-344. doi:10.1097/00000441-200212000-00011
12. Verhelst D, Monge M, Meynard JL, et al. Fanconi syndrome and renal failure induced by tenofovir: a first case report. Am J Kidney Dis. 2002;40(6):1331-1333. doi:10.1053/ajkd.2002.36924
13. Malik A, Abraham P, Malik N. Acute renal failure and Fanconi syndrome in an AIDS patient on tenofovir treatment--case report and review of literature. J Infect. 2005;51(2):E61-65. doi:10.1016/j.jinf.2004.08.031
14. Gracey DM, Snelling P, McKenzie P, et al. Tenofovir-associated Fanconi syndrome in patients with chronic hepatitis B monoinfection. Antivir Ther. 2013;18(7):945-948. doi:10.3851/IMP2649
15. Gallant JE, Deresinski S. Tenofovir disoproxil fumarate. Clin Infect Dis. 2003;37(7):944-950. doi:10.1086/378068
16. McEvoy GK. AHFS Drug Information. Oncology Issues. 1994;9(5):12-13. doi:10.1080/10463356.1994.11904493
17. Fernandez-Fernandez B, Montoya-Ferrer A, Sanz AB, et al. Tenofovir nephrotoxicity: 2011 update. AIDS Res Treat. 2011;2011:354908. doi:10.1155/2011/354908
18. Ueaphongsukkit T, Gatechompol S, Avihingsanon A, et al. Tenofovir alafenamide nephrotoxicity: a case report and literature review. AIDS Res Ther. 2021;18(1):53. doi:10.1186/s12981-021-00380-w
19. Nelson MR, Katlama C, Montaner JS, et al. The safety of tenofovir disoproxil fumarate for the treatment of HIV infection in adults: the first 4 years. AIDS. 2007;21(10):1273-1281. doi:10.1097/QAD.0b013e3280b07b33
20. Labarga P, Barreiro P, Martin-Carbonero L, et al. Kidney tubular abnormalities in the absence of impaired glomerular function in HIV patients treated with tenofovir. AIDS. 2009;23(6):689. doi:10.1097/QAD.0b013e3283262a64
21. Viganò M, Brocchieri A, Spinetti A, et al. Tenofovir-induced Fanconi syndrome in chronic hepatitis B monoinfected patients that reverted after tenofovir withdrawal. Journal of Clinical Virology. 2014;61(4):600-603. doi:10.1016/j.jcv.2014.09.016
22. Hwang HS, Park CW, Song MJ. Tenofovir-associated Fanconi syndrome and nephrotic syndrome in a patient with chronic hepatitis B monoinfection. Hepatology. 2015;62(4):1318-1320. doi:10.1002/hep.27730
23. Buldukoglu OC, Akın M. Tenofovir Disoproxil Fumarate as a Possible Agent of Drug-Induced Anemia in a Liver Transplant Patient. Akd Tıp D. 2021;7(1):158-160. Accessed May 12, 2024. https://dergipark.org.tr/tr/pub/akd/issue/67029/1047396
24. Baranek B, Wang S, Cheung AM, et al. The effect of tenofovir disoproxil fumarate on bone mineral density: a systematic review and meta-analysis. Antivir Ther. 2020;25(1):21-32. doi:10.3851/IMP3346
25. Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560-1599. doi:10.1002/hep.29800