Urinary ß-2 Microglobulin Levels Sensitively Altered in an Osteomalacia Patient Receiving Add-on Adefovir Dipivoxil Therapy for Hepatitis B Virus Infection.

ABSTRACT

Adefovir dipivoxil (ADV) is effective for hepatitis B virus (HBV) infection; however, ADV may provoke renal injury resulting in osteomalacia, and this side effect is seldom recognized until bone fractures emerge. We herein present a 66-year-old woman with HBV infection who received ADV for 6 years. Although she exhibited no sign of bone fractures, her urinary ß-2 microglobulin (ß2MG) level increased to 83,837 µg/L and scintigraphy revealed minimal fractures of the third rib. ADV was subsequently reduced and her urinary ß2MG rapidly fell to 3,637 µg/L. Conversely, her urinary N-acetyl-ß-D-glucosaminidase, and serum phosphate, alkaline phosphatase levels did not respond.