| Objective To analyze the clinical characteristics, treatment, and prognosis of hypophosphatemia osteomalacia induced by the small dose of adefovir dipivoxil. Methods According to the clinical data of two cases of hypophosphatemia osteomalacia induced by the small dose of adefovir dipivoxil, who were diagnosed in our hospital, and combining with domestic and overseas literatures, we summarized the clinical characteristics, treatment, prognosis, and the early diagnosis of this disease. Results There were 12 patients with hypophosphatemia osteomalacia induced by small dose of adefovir dipivoxil, which was used for the treatment of chronic hepatitis B, including 9 males and 3 females. All these patients were Asian, with age from 22 to 74 years old. Hypophosphatemia was found after taking adefovir dipivoxil for 18-64 months. And the concentration of phosphorus ranged from 0.37 to 0.79 mmol/L. The serum calcium level was normal or low, and the serum potassium level was low. They all had varying degrees of osteoporosis. The prognosis was good after taking calcium, calcitriol, and strontium ranelate. Conclusion The hypophosphatemia osteomalacia induced by small dose of adefovir dipivoxil is rarely in clinical practice, which can be easily missed. Those patients who takes adefovir dipivoxil, no matter what the dosage is, should take periodical examination including serum creatinine, serum calcium, blood phosphorus, and bone mineral density to monitor the occurrence of renal damage and hypophosphatemia, in order to make an early diagnosis. Adefovir dipivoxil should be discontinued immediately when any index showing abnormal. Other anti-viral drugs can be used, icluding interferon, entecavir, etc. |