Abstract
We present 2 human immunodeficiency virus-infected patients with tenofovir disoproxil fumarate-induced Fanconi syndrome, leading to osteomalacia. Intracellular tenofovir diphosphate levels were measured in 1 patient and were found to be very high, with plasma tenofovir levels just slightly elevated. Fibroblast growth factor-23, a phosphaturic hormone, was decreased in both patients and is therefore unlikely to have a pathophysiological role in this pathology. The different potential factors contributing to the development of tenofovir-related kidney proximal tubular dysfunction are discussed and the data presented may help to further elucidate its pathogenesis.
MeSH terms
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Adenine / adverse effects
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Adenine / analogs & derivatives*
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Adenine / blood
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Adenine / therapeutic use
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Adult
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Anti-HIV Agents / adverse effects*
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Anti-HIV Agents / therapeutic use
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Diphosphates / blood
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Fanconi Syndrome / chemically induced*
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Fanconi Syndrome / diagnosis
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Fanconi Syndrome / diagnostic imaging
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Fanconi Syndrome / virology
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HIV Infections / complications
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HIV Infections / drug therapy*
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Humans
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Male
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Middle Aged
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Organophosphonates / adverse effects*
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Organophosphonates / blood
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Organophosphonates / therapeutic use
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Osteomalacia / chemically induced*
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Osteomalacia / diagnosis
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Osteomalacia / virology
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Radionuclide Imaging
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Tenofovir
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Whole Body Imaging
Substances
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Anti-HIV Agents
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Diphosphates
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Organophosphonates
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Tenofovir
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Adenine