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The Development of Bone Disease with Myopathy in Two HIV Patients
on Tenofovir-containing HAART
Osteomalacia (aka
adult rickets) is a bone
disease characterized by a gradually softening of
and bending of the bones that may cause significant pain to those
affected. It may be due to lack of vitamin
D or to renal
tubular dysfunction.
In
this report, researchers describe two cases in which osteomalacia
developed in patients on tenofovir
(Viread)-containing HAART in the context of Fanconi
syndrome (renal tubular dysfunction) with hypophosphataemia (low
concentrations of phosphates in the circulating blood).
Bone
pain was the presenting feature and myopathy followed in one case.
Disability
was reversed with withdrawal of the tenofovir and with mineral supplementation.
The
cases highlight the importance of considering the diagnosis of osteomalacia
in patients treated with tenofovir, according to the authors.
The
authors conclude, “A possible association with incipient acute
renal failure, particularly during nonsteroidal anti-inflammatory
drug (NSAID) use, needs further investigation.”
Department of Infectious Diseases and
Tropical Medicine, North Manchester General Hospital, Crumpsall,
Manchester, UK.
09/21/05
Reference
M
J Parsonage and others. The development of hypophosphataemic osteomalacia
with myopathy in two patients with HIV infection receiving tenofovir
therapy. HIV Medicine 6(5): 341-346. September 2005.
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