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Article Synopsis
  • Hypophosphatemic osteomalacia is a rare condition marked by low phosphate levels, which can occur due to genetic or acquired factors, and a case study discusses its management and prognosis when caused by specific antiviral drugs.
  • A 55-year-old man with chronic hepatitis B experienced symptoms like chest pain and fatigue after switching from adefovir to tenofovir, leading to the diagnosis of drug-induced hypophosphatemic osteomalacia.
  • Treatment included stopping the problematic drugs, switching to entecavir, and recommending dietary changes and supplements, which resulted in improved phosphate levels and resolution of symptoms.
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Tenofovir-Associated Kidney Dysfunction and Bone Fracture: A Case Report and Literature Review.

Cureus

June 2024

Department of Internal Medicine, Sri Devaraj Urs Academy of Higher Education and Research, Kolar, IND.

Tenofovir is an integral part of antiretroviral therapy used to treat HIV. Long-term use of tenofovir has been associated with decreased glomerular filtration rate, leading to chronic kidney disease, as well as acidosis, electrolyte imbalances, and tubular dysfunction. Tenofovir can also disrupt bone health by decreasing renal phosphate absorption, contributing to osteomalacia.

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Tumor-induced osteomalacia (TIO) is an exceedingly rare paraneoplastic condition characterized by hypophosphatemia, osteomalacia, fragility fractures, and fatigue. A 39-year-old man was assessed for hemoptysis, pathological rib fractures, and fatigue, and was found to have a chest mass with lung metastasis. Biopsy of the mass suggested high-grade epithelioid and spindle cell neoplasm.

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Article Synopsis
  • - An 80-year-old woman experienced chronic bromine poisoning from taking OTC medication with bromovalerylurea (BVU), leading to drug-induced partial Fanconi syndrome and osteomalacia.
  • - The patient's health improved after she stopped consuming the bromide-containing medication.
  • - This case emphasizes the dangers of long-term exposure to BVU found in OTC drugs and the need for caution when using such medications.
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Background: Patients after kidney transplantation need to take long-term immunosuppressive and other drugs. Some of these drug side effects are easily confused with the symptoms of Fanconi syndrome, resulting in misdiagnosis and missed diagnosis, and causing serious consequences to patients. Therefore, improving awareness, early diagnosis and treatment of Fanconi syndrome after kidney transplantation is critical.

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