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Case Report
- Multiple Stress Fractures Related to Low-dose Adefovir Dipivoxil Treatment in a Patient with Chronic Hepatitis B: A Case Report
- Chul-Hyun Park, M.D., Ph.D., Hyo-Sae Ahn, M.D., Dong-Chul Lee, M.D., Ph.D.
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Journal of the Korean Fracture Society 2014;27(4):327-331.
DOI: https://doi.org/10.12671/jkfs.2014.27.4.327
Published online: October 20, 2014
Department of Orthopedic Surgery, Yeungnam University College of Medicine, Daegu, Korea.
- Address reprint requests to: Chul-Hyun Park, M.D., Ph.D. Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyeonchung-ro, Nam-gu, Daegu 705-703, Korea. Tel: 82-53-620-3640, Fax: 82-53-628-4020, chpark77@naver.com
• Received: April 23, 2014 • Revised: June 16, 2014 • Accepted: July 30, 2014
Copyright © 2014 The Korean Fracture Society. All rights reserved.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
- Stress fractures typically result from repeated abnormal mechanical loading to the bones. In particular, multiple stress fractures may occur in patients with systemic disease, such as rheumatoid arthritis, osteoporosis, or osteoarthritis. Adefovir dipivoxil (ADV), a nucleotide analogue of adenosine monophosphate, very rarely causes severe hypophosphatemia when using a low dosage of 10 mg daily for treatment of chronic hepatitis B. To the best of our knowledge, in English literature, this is the first report of multiple stress fractures in a chronic hepatitis B patient who has been treated with a low dosage of ADV. We think it is important to consider that use of ADV in a patient with chronic hepatitis B could be a risk factor for stress fractures.
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XML DownloadMultiple Stress Fractures Related to Low-dose Adefovir Dipivoxil Treatment in a Patient with Chronic Hepatitis B: A Case Report
Fig. 1
Magnetic resonance image showed diffuse high signal intensity at the right distal tibia and talus (A), left distal tibia and talus (B), and distal femur and proximal tibia (C) on coronal T2-weighted images.
Fig. 2
(A) Whole body bone scan taken at the initial visit showed multiple hot uptakes at multiple ribs, right sacroiliac joint, both distal femurs and proximal tibias, and both distal tibias and tali. (B) Whole body bone scan taken at one year after treatment showed decreased uptake.
Fig. 1
Fig. 2
Multiple Stress Fractures Related to Low-dose Adefovir Dipivoxil Treatment in a Patient with Chronic Hepatitis B: A Case Report
