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Bone Pain Due to Fractures Revealing Osteomalacia Related to Tenofovir-Induced Proximal Renal Tubular Dysfunction in a Human Immunodeficiency Virus-Infected Patient

2009; Lippincott Williams & Wilkins; Volume: 15; Issue: 2 Linguagem: Inglês

10.1097/rhu.0b013e31819c20d8

1536-7355

Serge Perrot, E. Aslangul, Tali Szwebel, Nadine Caillat‐Vigneron, Claire Le Jeunne,

Pharmacological Effects and Toxicity Studies

In Brief Tenofovir is a nucleoside reverse transcription inhibitor used to treat human immunodeficiency virus patients with early treatment failure. Increasing numbers of cases of tubular dysfunction and Fanconi syndrome have been reported in patients treated with tenofovir, after the detection of biochemical abnormalities during routine assessments. Some patients have acute renal failure, and bone involvement is observed in rare cases. We describe a case of chronic metabolic complications with bone fractures related to tenofovir treatment. Several factors that increased the renal toxicity of tenofovir included low body mass index, concomitant use of nonsteroidal anti-inflammatory agents, and other antiretroviral drugs, including ritonavir. This woman had gradually increasing leg pain, laboratory findings of Fanconi syndrome with osteomalacia, and a bone scan suggesting multiple fissure fractures. All resolved with discontinuation of tenofovir.