软骨病在的开发一肝以后移植耐心的收到 adefovir dipivoxil

• 作者: Hiroshi Kudo Katsuharu Hirano Kazuto Tajiri Kengo Kawai Masami Minemura Satoshi Yasumura Terumi Takahara Toshiro Sugiyama Yasuhiro Nakayama Yoshiharu Tokimitsu Yoshinari Atarashi Yutaka Yata
• 来源期刊: 世界肝病学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Hepatitis B virus OSTEOMALACIA ADEFOVIR dipivoxil LIVING donor-related liver transplantation TACROLIMUS
• 年，卷（期）: 2010,（12）
• 页码范围: 442-446
• 页数: 5页
• 分类号: R730.4

摘要

We report the case of a patient treated with living donor-related liver transplantation who suffered from osteomalacia during adefovir dipivoxil (ADV)-containing antiviral therapy for lamivudine-resistant hepatitis B virus infection. The patient had generalized bone pain,with severe hypophosphatemia after 20 mo of ADV therapy. Radiographic studies demonstrated the presence of osteomalacia. The peak plasma ADV level was 38 ng/mL after administration of ADV at 10mg/day. It was also found that ADV affected the metabolism of tacrolimus,a calcineurin-inhibitor,and caused an increase in the plasma levels of tacrolimus. The disability was reversed with the withdrawal of ADV and with mineral supplementation. ADV can cause an elevation of plasma tacrolimus levels,which may be associated with renal dysfunction. High levels of ADV and tacrolimus can cause nephrotoxicity and osteomalacia. This case highlights the importance of considering a diagnosis of osteomalacia in liver transplantation recipients treated with both ADV and tacrolimus.