Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Bone Histology of Two Cases with Osteomalacia Related to Low-dose Adefovir
Rikako HiramatsuYoshifumi UbaraNaoki SawaEiko HasegawaMasahiro KawadaAya ImafukuKeiichi SumidaJunichi HoshinoKenmei Takaichi
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JOURNAL OPEN ACCESS

2016 Volume 55 Issue 20 Pages 3013-3019

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Abstract

We performed a bone histomorphometric analysis in two patients demonstrating Fanconi syndrome with hypophosphatemia, adefovir-related bone disease and chronic hepatitis B infection. Both patients had osteomalacia, but showed two different histological patterns. The osteoid volume of the patient without risedronate increased with [(osteoid volume/ bone volume)×100=18.6%]. However, the osteoid volume of the patient receiving risedronate without vitamin D analogue showed a greater increase of 53.8%. In both patients bone pain and hypophosphatemia subsided soon after the discontinuation of adefovir and the administration of phosphate derivative. These findings show that bisphosphonate may worsen this disease when this drug is administered without a vitamin D analogue.

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© 2016 by The Japanese Society of Internal Medicine
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