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Low-Dose Adefovir-Induced Hypophosphatemic Osteomalacia on Whole-Body Bone Scintigraphy

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Author(s)
Sung Hoon KimKyoung Sook WonBong-Il SongIl JoSeok Kil Zeon
Keimyung Author(s)
Won, Kyoung SookSong, Bong IlZeon, Seok Kil
Department
Dept. of Nuclear Medicine (핵의학)
Journal Title
Nuclear Medicine and Molecular Imaging
Issued Date
2013
Volume
47
Issue
4
Abstract
While adefovir dipivoxil (ADV) effectively suppresses the
hepatitis B virus, it can cause proximal renal tubular dysfunction
leading to phosphate wasting [1, 2]. The safety of
low-dose ADV (a dose of 10 mg/day), which does not
induce clinically significant nephrotoxicity, is well recognized,
but a few cases of hypophosphatemic osteomalacia
(HO) caused by low-dose ADV therapy have recently been
reported [3–6].
Although HO induced by low-dose ADV therapy is rare,
the presence of bone pain in patients treated with ADV
should be monitored. Bone scintigraphy can be performed
to confirm the occurrence of osteomalacia and to determine
the disease extent. Bone scintigraphic and radiological image
findings with a brief review of the literature are
presented in this article.
We report two cases of HO induced by low-dose ADV
therapy that showed multifocal increased radiotracer uptakes
in the bilateral bony ribs, spines, pelvic bones and lower
extremities on whole-body bone scintigraphy (Figs. 1 and 2).
Bone pain gradually improved after phosphate supplementation
and by changing the antiviral agent.
Whole-body bone scintigraphy is a highly sensitive imaging
tool and can show disease extent at once in the setting of
the wide range of the clinical spectrum with nonspecific
radiological findings [5]. Furthermore, frequent involvement
of the lower extremities, as a result of maximum weight
bearing, could be an additional scintigraphic clue for the
diagnosis of HO [6, 7]. These cases could be helpful for both
clinicians prescribing ADVand nuclear physicians to prevent
delayed diagnosis and plan further appropriate treatment.
Keimyung Author(s)(Kor)
원경숙
송봉일
전석길
Publisher
School of Medicine
Citation
Sung Hoon Kim et al. (2013). Low-Dose Adefovir-Induced Hypophosphatemic Osteomalacia on Whole-Body Bone Scintigraphy. Nuclear Medicine and Molecular Imaging, 47(4), 294–296. doi: 10.1007%2Fs13139-013-0223-7
Type
Article
ISSN
1869-3474
DOI
10.1007%2Fs13139-013-0223-7
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/33563
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학)
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