Reactions 1704, p219 - 2 Jun 2018
Fanconi syndrome: case report
A 73-year-old man developed Fanconi syndrome (FS)
following interaction between ledipasvir/sofosbuvir for
hepatitis C and tenofovir disoproxil fumarate for HIV [routes,
dosages, durations of treatment to reaction onset not stated].
The man, who had a history of HIV, started receiving
tenofovir disoproxil fumarate, ritonavir, atazanavir and
efavirenz. He was also receiving ledipasvir/sofosbuvir for
hepatitis C. Later, he presented with nausea, vomiting and
chest pain, and sent to the emergency department. His
laboratory values revealed serum bicarbonate level of
6.0 mEq/L, serum potassium level of 2.3 mEq/L, serum
chloride level of 118 mEq/L and serum creatinine level of
3.3 mg/dL. His urine studies showed urine protein level of
27 mg/dL, urine glucose level of 573 mg/dL, urine sodium level
of 31 mEq/L and urine creatinine level of 16 mg/dL. In addition
to that, fractional excretion of transtubular potassium
(11.98 mEq/L) and sodium 4.8% were indicative of renal
potassium wasting. Subsequently, he was diagnosed with FS,
which supposed to be secondary to tenofovir disoproxil
fumarate and ledipasvir/sofosbuvir interaction.
Tenofovir disoproxil fumarate and ledipasvir/sofosbuvir
were discontinued, which resulting in his electrolyte
Author comment: "Fanconi syndrome (FS) was thought to
be secondary to [ledipasvir/sofosbuvir] and tenofovir
disoproxil fumarate (TDF) interaction".
Sharma AV. Drug-drug interaction leading to fanconi’s syndrome in a geriatric
patient. Journal of the American Geriatrics Society 66 (Suppl. 2): S17, Apr 2018.
Available from: URL: http://doi.org/10.1111/jgs.15376 [abstract] -
Reactions 2 Jun 2018 No. 17040114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved