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7270654 
Journal Article 
A case of entecavir-induced Fanconi syndrome 
Fujii, T; Kawasoe, K; Ohta, A; Nitta, K 
2019 
8 
4 
256-260 
English 
Acquired Fanconi syndrome has been associated with the long-term ingestion of several nucleoside analogs used to treat chronic hepatitis B virus infection. However, the nucleoside analog entecavir has not been found to cause nephrotoxicity. We report a case of entecavir-induced Fanconi syndrome. Our patient was a 73-year-old man admitted to our hospital because of renal dysfunction. He also presented with hyperaminoaciduria, renal diabetes, phosphaturia, hypophosphatemia, hypokalemia, hypouricemia, and hyperchloremic metabolic acidosis, supporting a diagnosis of Fanconi syndrome. In this case, the cause of Fanconi syndrome was most likely entecavir, which had been administered as needed depending on his renal function for 5 years. After drug discontinuation and replacement with tenofovir alafenamide fumarate therapy once a week, the patient's kidney function recovered and electrolyte anomalies partially improved. We highlight the fact that entecavir may induce severe renal dysfunction, which can cause the development of Fanconi syndrome; therefore, close monitoring of proximal tubular function is recommended during entecavir therapy. 
Antiviral Agents; 0; Nucleosides; entecavir; 5968Y6H45M; Guanine; 5Z93L87A1R; GS-7340; EL9943AG5J; Adenine; JAC85A2161; Index Medicus; Chronic hepatitis B; Entecavir; Nucleotide analog; Fanconi syndrome; Adenine -- analogs & derivatives; Hypokalemia -- etiology; Antiviral Agents -- therapeutic use; Acidosis -- etiology; Adenine -- therapeutic use; Humans; Hypophosphatemia -- etiology; Male; Treatment Outcome; Aged; Withholding Treatment; Guanine -- analogs & derivatives; Fanconi Syndrome -- blood; Hepatitis B, Chronic -- complications; Guanine -- adverse effects; Acute Kidney Injury -- complications; Acute Kidney Injury -- chemically induced; Acute Kidney Injury -- blood; Fanconi Syndrome -- drug therapy; Nucleosides -- adverse effects; Fanconi Syndrome -- chemically induced; Nucleosides -- toxicity; Acute Kidney Injury -- pathology; Guanine -- toxicity; Hepatitis B, Chronic -- drug therapy; Fanconi Syndrome -- urine