Clin Osteol 2021; 26(1): 22-28

«aľká hypofosfatemická osteomalácia ako komplikácia antivirotickej liečby hepatitídy B: kazuistikaCase reports

©kamlová Martina1,2, Skladaný Ubomír1, Kmečová Zlata1
1 Department of Internal medicine II of Slovak Medical University, F. D. Roosevelt University Hospital in Banská, Bystrica, Slovakia
2 Department of Rheumatology, Medical Faculty of Slovak Medical University and National Institute of Rheumatic, Diseases, Pieą»any, Slovakia

Chronická antivirotická liečba adefovirom a jemu príbuznými liekmi (tenofovir, cedofovir) je potencionálna príčina »aľkej hypofosfatemickej osteomalácie. Uvádzame popis prípadu 68-ročnej pacientky s chronickou hepatitídou typu B, dlhodobo na antivirotickej liečbe adefovirom. Prítomná generalizovaná kostná algia, pokles výąky, svalová adynamia. Postupne sa manifestovali subkapitálne fraktúry oboch femurov, fraktúry panvy, rebier, metatarzov, multietáľové vertebrálne fraktúry. Laboratórne nálezy pozostávali z »aľkej hypofosfatémie, normokalcémie, µahkej hypokalémie a významnej elevácie ALP (alkalickej fosfatázy). Močový nález tvorila proteinúria a glykozúria. Denzitometricky v pásme miernej osteoporózy. Celotelová gamagrafia skeletu preukázala početné loľiská zvýąenej osteogenézy. Bola vyslovená suspekcia na hypofosfatemickú osteomaláciu ako dôsledok adefovirom indukovanej tubulopatie s excesívnou stratou fosfátov. Terapia pozostávala zo zmeny antivirotickej liečby, suplementácie fosfátov, vitamínu D a vápnika per os. Následný priebeh bol charakterizovaný postupným zlepąovaním klinického, laboratórneho aj morfologického nálezu.

Keywords: adefovir; hypofosfatémia; osteomalácia; tubulopatia

Published: June 11, 2021  Show citation

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©kamlová M, Ubomír S, Kmečová Z. «aľká hypofosfatemická osteomalácia ako komplikácia antivirotickej liečby hepatitídy B: kazuistika. Clinical Osteology. 2021;26(1):22-28.
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