丙酚替诺福韦用于范科尼综合征恩替卡韦治疗失败的慢性乙型肝炎患者挽救治疗:个案报道并文献复习

Tenofovir alafenamide as the rescue therapy for chronic hepatitis B patient with Fanconi syndrome and entecavir treatment failure:a case report and literature review

慢性乙型肝炎治疗的关键是抗病毒治疗。临床上长期使用阿德福韦酯或富马酸替诺福韦二吡呋酯抗病毒治疗的慢性乙型肝炎患者可发生范科尼综合征等罕见不良反应,临床上多采用恩替卡韦作为挽救治疗方案。但对于恩替卡韦治疗失败的范科尼综合征患者,后续抗病毒治疗的证据尚不多见。现报道1例恩替卡韦治疗失败的范科尼综合征患者,采用丙酚替诺福韦治疗有效,并对相关文献进行复习,为此类患者的治疗提供依据。

Antiviral therapy is the key for management of chronic hepatitis B.Fanconi syndrome is a rare side effect in chronic hepatitis B patients who take long-term therapy of adefovir dipivoxil or tenofovir disoproxil fumarate.Usually entecavir is chosen as rescue therapy for these patients.There is little evidence for rescue therapy for chronic hepatitis B patients who comorbid with Fanconi syndrome and experienced entecavir treatment failure.We reported a case of Fanconi syndrome patient who underwent entecavir treatment failure and was rescued successfully with tenofovir alafenamide.Also,we reviewed related literatures.Our case might provide evidence for management of chronic hepatitis B patients who experienced entecavir treatment failure and comorbid with Fanconi syndrome.