RESUMO
We report two cases in which osteomalacia developed in patients on tenofovir-containing highly active antiretroviral therapy (HAART) in the context of Fanconi syndrome with hypophosphataemia. Bone pain was the presenting feature and myopathy followed in one case. Disability was reversed with withdrawal of the drug and with mineral supplementation. The cases highlight the importance of considering the diagnosis of osteomalacia in patients treated with tenofovir. A possible association with incipient acute renal failure, particularly during nonsteroidal anti-inflammatory drug (NSAID) use, needs further investigation.
Assuntos
Adenina/análogos & derivados , Fármacos Anti-HIV/efeitos adversos , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Infecções por HIV/tratamento farmacológico , Organofosfonatos/efeitos adversos , Osteomalacia/induzido quimicamente , Adenina/efeitos adversos , Síndrome de Fanconi/induzido quimicamente , Feminino , Humanos , Hipofosfatemia/induzido quimicamente , Masculino , Pessoa de Meia-Idade , Doenças Musculares/induzido quimicamente , Inibidores da Transcriptase Reversa/efeitos adversos , TenofovirRESUMO
Both growth hormone and sex steroid deficiencies are known to affect quality of life adversely. Hypogonadism is not infrequent in patients with AIDS and due mostly to hypothalamic or end-organ failure. The prevalence of GH deficiency is unknown. We report two cases of GH deficiency in AIDS, one of which was associated with gonadotroph failure. The significance of GH deficiency in HIV infection in terms of its potential effects on disease progression is discussed. Further studies are required to assess the prevalence of GH deficiency and to clarify its role in the immunopathogenesis of AIDS.