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学科主题: 传染病学
题名:
阿德福韦酯相关范科尼综合征合并脊髓病及周围神经病
其他题名: Fanconi syndrome complicated with spinal cord diseases and peripheral neuropathy related to adefovir dipivoxil
作者: 李璐; 宋红松; 蔡晧东
关键词: 阿德福韦酯 ; 范科尼综合征 ; 脊髓病 ; 周围神经系统疾病 ; Adefovir dipivoxil ; Fanconi syndrome ; Spinal cord diseases ; Peripheral nervous system diseases
刊名: 药物不良反应杂志
发表日期: 2014
DOI: 10.3760/cma.j.issn.1008-5734.2014.01.018
卷: 16, 期:1, 页:52-53
收录类别: 中国科技核心期刊 ; CSCD
文章类型: Journal Article
摘要: 1例63岁男性乙型肝炎肝硬化患者服用阿德福韦酯10 mg,1次/d.用药约3年半后出现双下肢麻木、无力,4年后出现步态不稳.实验室检查示血磷0.37 mmol/L;肌电图检查示双下肢深感觉径路传导阻滞,考虑脊髓病合并周围神经病.给予维生素B1、B12治疗后好转.约2个月后,患者再次出现双下肢麻木、无力.尿液检查:α1微球蛋白257.8 mg/L,微量白蛋白168 mg/L,N-乙酰-β-D-氨基葡萄糖苷酶90 U/L.骨密度检查提示骨量减少.考虑阿德福韦酯相关范科尼综合征.停用阿德福韦酯,改为口服恩替卡韦0.5 mg,1次/d,同时给予多维元素片、骨化三醇.18 d后复查,血磷0.75 mmol/L,下肢无力减轻.停用阿德福韦酯5个月后,患者可正常行走.实验室复查:尿α1微球蛋白32.8 mg/L,尿微量白蛋白14 mg/L,尿N-乙酰-β-D-氨基葡萄糖苷酶15 U/L,血磷0.90 mmol/L. A 63-year-old man with hepatitis B and cirrhosis received oral adefovir dipivoxil 10 mg once daily.About three and a half years after the start of the drug therapy,the patient developed numbness and weakness of lower limbs.He experienced unstable walking in the forth years.Laboratory tests revealed a serum phosphate level of 0.37 mmol/L.Electromyogram showed deep sensory pathway conduction block of bilateral lower limbs.The spinal cord diseases complicated with peripheral neuropathy was considered.After treatment with vitamin B1 and B12,the patient improved.About two months later,the symptoms of lower limb numbness and weakness relapsed.Urinalysis showed alpha 1-microglobulin 257.8 mg/L,microalbumin 168 mg/L and N-acetyl beta-D-glucosaminidase 90 U/L.Bone mineral density examination revealed osteopenia.The patient was diagnosed with Fanconi syndrome related to adefovir dipivoxil.Adefovir dipivoxil was stopped and his therapy was switched to oral entecavir 0.5 mg once daily.At the same time,he was given multivitamin and minerals tablets and calcitriol.Eighteen days later,the serum phosphate level rose to 0.75 mmo[/L and the degrees of lower limb weakness relieved.Five months later,he walked normally.Repeat laboratory tests showed the following levels:urine alpha 1-microglobulin 32.8 mg/L,microalbumin 14 mg/L,N-acetyl beta-D-glucosaminidase 15 U/L,and serum phosphate 0.90 mmol/L.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/70308
Appears in Collections:北京大学第三临床医学院_感染疾病科_期刊论文

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作者单位: 1.100191,北京大学第三医院感染疾病科
2.100191,北京大学第三医院神经内科
3.首都医科大学附属北京地坛医院肝病中心

Recommended Citation:
李璐,宋红松,蔡晧东. 阿德福韦酯相关范科尼综合征合并脊髓病及周围神经病[J]. 药物不良反应杂志,2014,16(1):52-53.
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