{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T11:44:01Z","timestamp":1774007041134,"version":"3.50.1"},"reference-count":19,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,10]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:p>Tenofovir disoproxil fumarate (TDF) is an antiretroviral drug widely used as a first-line treatment of hepatitis B virus (HBV) and HIV. Increasing evidence has emerged associating its use with the development of Fanconi syndrome, renal insufficiency and bone disease. We report a case of a 61-year-old woman with a remote history of liver transplant for cirrhosis due to HBV. Over 1\u2009year, the patient had recurrent falls, generalised myalgias and arthralgias, misdiagnosed as fibromyalgia. We discuss a complication of her transplant treatment regimen with the drug TDF leading to a rare but reversible disorder: tenofovir-induced Fanconi osteomalacia with renal phosphate wasting. Though recognised, this rare disorder was initially likely missed due to clinical unfamiliarity with the diagnosis, concomitant psychiatric symptoms and premature diagnostic closure.<\/jats:p>","DOI":"10.1136\/bcr-2020-240387","type":"journal-article","created":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T11:55:43Z","timestamp":1621857343000},"page":"e240387","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Tenofovir-induced osteomalacia with hypophosphataemia"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7266-2762","authenticated-orcid":false,"given":"Iulia","family":"Iatan","sequence":"first","affiliation":[{"name":"General Internal Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todd C","family":"Lee","sequence":"additional","affiliation":[{"name":"Clinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily G","family":"McDonald","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada"},{"name":"Clinical Practice Assessment Unit, Department of Medicine, McGill University Health Centre, Montreal, Quebec, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,5,24]]},"reference":[{"key":"2025082702350174000_14.5.e240387.1","doi-asserted-by":"crossref","first-page":"1557","DOI":"10.1016\/j.injury.2015.05.006","article-title":"Sensitivity and specificity of CT- and MRI-scanning in evaluation of occult fracture of the proximal femur","volume":"46","author":"Haubro","year":"2015","journal-title":"Injury"},{"key":"2025082702350174000_14.5.e240387.2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.090728"},{"key":"2025082702350174000_14.5.e240387.3","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s11914-017-0383-y","article-title":"Nutritional rickets and osteomalacia in the twenty-first century: revised concepts, public health, and prevention strategies","volume":"15","author":"Uday","year":"2017","journal-title":"Curr Osteoporos Rep"},{"key":"2025082702350174000_14.5.e240387.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp060278"},{"key":"2025082702350174000_14.5.e240387.5","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.bonr.2018.03.005","article-title":"Bone histomorphometry in the evaluation of osteomalacia","volume":"8","author":"Bhan","year":"2018","journal-title":"Bone Rep"},{"key":"2025082702350174000_14.5.e240387.6","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880170603"},{"key":"2025082702350174000_14.5.e240387.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocd.2005.11.001"},{"key":"2025082702350174000_14.5.e240387.8","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1007\/s11914-019-00529-7","article-title":"When low bone mineral density and fractures is not osteoporosis","volume":"17","author":"Jha","year":"2019","journal-title":"Curr Osteoporos Rep"},{"key":"2025082702350174000_14.5.e240387.9","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.09.3383"},{"key":"2025082702350174000_14.5.e240387.10","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2016.182"},{"key":"2025082702350174000_14.5.e240387.11","unstructured":"Hoff VWG . Fanconi syndrome. In: Davison AM , Stewart Cameron J , Grunfeld J , et al , eds. 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