{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T17:35:20Z","timestamp":1775151320544,"version":"3.50.1"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2004,5,1]],"date-time":"2004-05-01T00:00:00Z","timestamp":1083369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2004,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We diagnosed Fanconi's syndrome (phosphate depletion and dysfunction of the renal tubules) in three HIV+ patients. This was temporally related to their HIV treatment. Physicians caring for patients with HIV should recognize the association of this rare syndrome with antiretroviral medications and monitor their patients carefully.<\/jats:p>\n               <jats:p>Introduction: Fanconi's syndrome is caused by increased excretion of phosphate, glucose, amino acids, and other intermediary metabolites, and can result in osteomalacia.<\/jats:p>\n               <jats:p>Materials and Methods: We diagnosed this syndrome in three HIV+ patients.<\/jats:p>\n               <jats:p>Results: The first was a 43-year-old woman referred for multiple painful stress fractures. She demonstrated hypophosphatemia, metabolic acidosis, phosphaturia, glucosuria, and generalized aminoaciduria. These abnormalities resolved with oral phosphate replacement and discontinuation of the antiretroviral medication tenofovir. The second patient was a 39-year-old man with hypophosphatemia and bone pain. His symptoms improved with discontinuation of adefovir and supplementation of phosphate, potassium, and calcitriol. The third patient was a 48-year-old man who presented with symptomatic tetany caused by hypocalcemia (total serum calcium of 6.5 mg\/dl [8.5\u201310.5 mg\/dl]). Nine months before presentation, he had been treated with cidofovir for retinitis caused by cytomegalovirus. With calcium, phosphate, potassium, and calcitriol therapy, his laboratory abnormalities improved substantially, although he continues to require daily electrolyte replacement.<\/jats:p>\n               <jats:p>Conclusions: Each patient demonstrated generalized renal tubular dysfunction temporally related to treatment with antiretroviral drugs. The mechanism responsible for these abnormalities is not known; however, physicians caring for patients with HIV disease should recognize the association of Fanconi's syndrome with antiretroviral medications and monitor susceptible patients to prevent potential skeletal and neuromuscular complications.<\/jats:p>","DOI":"10.1359\/jbmr.2004.19.5.714","type":"journal-article","created":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T07:02:13Z","timestamp":1146121333000},"page":"714-721","source":"Crossref","is-referenced-by-count":101,"title":["Fanconi's Syndrome in HIV+ Adults: Report of Three Cases and Literature Review"],"prefix":"10.1093","volume":"19","author":[{"given":"Karen E","family":"Earle","sequence":"first","affiliation":[{"name":"Endocrinology Division, Department of Medicine, University of California at San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara","family":"Seneviratne","sequence":"additional","affiliation":[{"name":"Palo Alto Medical Foundation, Palo Alto, California, USA"},{"name":"Endocrinology Division, Department of Medicine, University of California at San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Shaker","sequence":"additional","affiliation":[{"name":"Department of Medicine, St. Luke's Medical Center, Milwaukee, Wisconsin, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dolores","family":"Shoback","sequence":"additional","affiliation":[{"name":"Endocrine Research Unit, Department of Veterans Affairs Medical Center and Department of Medicine, University of California at San Francisco, San Francisco, California, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2009,12,2]]},"reference":[{"key":"2024013019204462800_bib1","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s004310050937","article-title":"Fanconi-Bickel syndrome\u2014the original patient and his natural history, historical steps leading to the primary defect, and a review of the literature","volume":"157","author":"Santer","year":"1998","journal-title":"Eur J Pediatr"},{"key":"2024013019204462800_bib2","doi-asserted-by":"crossref","first-page":"1648","DOI":"10.1172\/JCI105856","article-title":"An experimental renal acidification defect in patients with hereditary fructose intolerance. II. Its distinction from classic renal tubular acidosis; its resemblance to the renal acidification defect associated with the Fanconi syndrome of children with cystinosis","volume":"47","author":"Morris","year":"1968","journal-title":"J Clin Invest"},{"key":"2024013019204462800_bib3","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1177\/088307380101600903","article-title":"Carnitine-deficient myopathy as a presentation of tyrosinemia type I","volume":"16","author":"Nissenkorn","year":"2001","journal-title":"J Child Neurol"},{"key":"2024013019204462800_bib4","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1023\/A:1005375629820","article-title":"Fanconi-Bickel syndrome presenting in neonatal screening for galactosaemia","volume":"20","author":"Muller","year":"1997","journal-title":"J Inherit Metab Dis"},{"key":"2024013019204462800_bib5","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1136\/jcp.23.6.487","article-title":"Effect of treatment on renal function in severe osteomalacia due to Wilson's disease","volume":"23","author":"Monro","year":"1970","journal-title":"J Clin Pathol"},{"key":"2024013019204462800_bib6","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1093\/clinchem\/35.11.2231","article-title":"Electrophoretic examination of proteinuria in Lowe's syndrome and other causes of renal tubular Fanconi syndrome","volume":"35","author":"Papadopoulos","year":"1989","journal-title":"Clin Chem"},{"key":"2024013019204462800_bib7","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1515\/JPEM.1999.12.3.363","article-title":"The molecular background of glycogen metabolism disorders","volume":"12","author":"Elpeleg","year":"1999","journal-title":"J Pediatr Endocrinol Metab"},{"key":"2024013019204462800_bib8","first-page":"425","article-title":"The development of cadmium-induced proteinuria, impaired renal function, and osteomalacia in alkaline battery workers","volume":"38","author":"Adams","year":"1969","journal-title":"Q J Med"},{"key":"2024013019204462800_bib9","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/0002-9343(87)90081-7","article-title":"Hypophosphatemic osteomalacia and adult Fanconi syndrome due to light-chain nephropathy. Another form of oncogenous osteomalacia","volume":"82","author":"Rao","year":"1987","journal-title":"Am J Med"},{"key":"2024013019204462800_bib10","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/S0272-6386(12)80820-1","article-title":"Aminoglycoside-induced Fanconi's syndrome","volume":"23","author":"Melnick","year":"1994","journal-title":"Am J Kidney Dis"},{"key":"2024013019204462800_bib11","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1053\/ejpn.2002.0585","article-title":"Fanconi syndrome caused by sodium valproate: Report of three severely disabled children","volume":"6","author":"Yoshikawa","year":"2002","journal-title":"Eur J Paediatr Neurol"},{"key":"2024013019204462800_bib12","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/S0022-3476(68)80124-6","article-title":"Acute reversible renal tubular dysfunction following intoxication with methyl-3-chromone","volume":"73","author":"Otten","year":"1968","journal-title":"J Pediatr"},{"key":"2024013019204462800_bib13","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1001\/archinte.1979.03630390032014","article-title":"Nephrotoxicity of paraquat in man","volume":"139","author":"Vaziri","year":"1979","journal-title":"Arch Intern Med"},{"key":"2024013019204462800_bib14","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1016\/S0272-6386(96)90476-X","article-title":"Fanconi's syndrome and tubulointerstitial nephritis in association with L-lysine ingestion","volume":"28","author":"Lo","year":"1996","journal-title":"Am J Kidney Dis"},{"key":"2024013019204462800_bib15","first-page":"62","article-title":"Fanconi syndrome caused by degraded tetracycline","volume":"54","author":"Varavithya","year":"1971","journal-title":"J Med Assoc Thai"},{"key":"2024013019204462800_bib16","doi-asserted-by":"crossref","first-page":"1576","DOI":"10.1136\/bmj.283.6306.1576-a","article-title":"Lactic acidosis and Fanconi's syndrome due to degraded tetracycline","volume":"283","author":"Montoliu","year":"1981","journal-title":"BMJ"},{"key":"2024013019204462800_bib17","doi-asserted-by":"crossref","first-page":"1846","DOI":"10.1128\/AAC.41.8.1846","article-title":"Fanconi syndrome associated with cidofovir therapy","volume":"41","author":"Vittecoq","year":"1997","journal-title":"Antimicrob Agents Chemother"},{"key":"2024013019204462800_bib18","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1046\/j.1523-1755.1999.00748.x","article-title":"HIV-associated nephropathy","volume":"56","author":"Klotman","year":"1999","journal-title":"Kidney Int"},{"key":"2024013019204462800_bib19","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1097\/00002030-200101050-00027","article-title":"Renal tubular acidosis and hypophosphataemia after treatment with nucleoside reverse transcriptase inhibitors","volume":"15","author":"Morris","year":"2001","journal-title":"AIDS"},{"key":"2024013019204462800_bib20","doi-asserted-by":"crossref","first-page":"1331","DOI":"10.1053\/ajkd.2002.36924","article-title":"Fanconi syndrome and renal failure induced by tenofovir: A first case report","volume":"40","author":"Verhelst","year":"2002","journal-title":"Am J Kidney Dis"},{"key":"2024013019204462800_bib21","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1053\/ajkd.2003.50037","article-title":"Drug-induced Fanconi's syndrome","volume":"41","author":"Izzedine","year":"2003","journal-title":"Am J Kidney Dis"},{"key":"2024013019204462800_bib22","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/S0163-4453(03)00082-3","article-title":"Fanconi-like syndrome and rhabdomyolysis in a person with HIV infection on highly active antiretroviral treatment including tenofovir","volume":"47","author":"Callens","year":"2003","journal-title":"J Infect"},{"key":"2024013019204462800_bib23","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1097\/00002030-200304110-00026","article-title":"Renal lesions in HIV-1-positive patient treated with tenofovir","volume":"17","author":"Creput","year":"2003","journal-title":"AIDS"},{"key":"2024013019204462800_bib24","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1086\/368314","article-title":"Tenofovir-related nephrotoxicity in human immunodeficiency virus-infected patients: Three cases of renal failure, Fanconi syndrome, and nephrogenic diabetes insipidus","volume":"36","author":"Karras","year":"2003","journal-title":"Clin Infect Dis"},{"key":"2024013019204462800_bib25","first-page":"3691","volume-title":"The Metabolic and Molecular Bases of Inherited Diseases","author":"Bergoron","year":"1995"},{"key":"2024013019204462800_bib26","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1111\/j.1365-2265.1995.tb02621.x","article-title":"Osteomalacia associated with adult Fanconi's syndrome: Clinical and diagnostic features","volume":"43","author":"Clarke","year":"1995","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2024013019204462800_bib27","first-page":"32","article-title":"Update on mitochondrial toxicity: Where are we now?","volume":"8","author":"Walker","year":"2003","journal-title":"J HIV Ther"},{"key":"2024013019204462800_bib28","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1177\/135965350300800311","article-title":"Polyphenotypic expression of mitochondrial toxicity caused by nucleoside reverse transcriptase inhibitors","volume":"8","author":"Miller","year":"2003","journal-title":"Antivir Ther"},{"key":"2024013019204462800_bib29","first-page":"125","article-title":"Mitochondrial encephalomyopathy and hypoparathyroidism associated with a duplication and a deletion of mitochondrial deoxyribonucleic acid","volume":"83","author":"Tengan","year":"1998","journal-title":"J Clin Endocrinol Metab"},{"key":"2024013019204462800_bib30","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1081\/NCN-100002341","article-title":"Human renal organic anion transporter 1 (hOAT1) and its role in the nephrotoxicity of antiviral nucleotide analogs","volume":"20","author":"Cihlar","year":"2001","journal-title":"Nucleosides Nucleotides Nucleic Acids"},{"key":"2024013019204462800_bib31","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1681\/ASN.V113383","article-title":"Cytotoxicity of antiviral nucleotides adefovir and cidofovir is induced by the expression of human renal organic anion transporter 1","volume":"11","author":"Ho","year":"2000","journal-title":"J Am Soc Nephrol"},{"key":"2024013019204462800_bib32","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1053\/hupa.2001.25586","article-title":"Adefovir nephrotoxicity: Possible role of mitochondrial DNA depletion","volume":"32","author":"Tanji","year":"2001","journal-title":"Hum Pathol"},{"key":"2024013019204462800_bib33","doi-asserted-by":"crossref","first-page":"467","DOI":"10.2165\/00002018-200023060-00001","article-title":"Toxicity of antiretroviral nucleoside and nucleotide analogues: Is mitochondrial toxicity the only mechanism?","volume":"23","author":"Moyle","year":"2000","journal-title":"Drug Saf"},{"key":"2024013019204462800_bib34","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1128\/AAC.46.3.716-723.2002","article-title":"Assessment of mitochondrial toxicity in human cells treated with tenofovir: Comparison with other nucleoside reverse transcriptase inhibitors","volume":"46","author":"Birkus","year":"2002","journal-title":"Antimicrob Agents Chemother"}],"container-title":["Journal of Bone and Mineral Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1359%2Fjbmr.2004.19.5.714","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/19\/5\/714\/56475093\/5650190504.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jbmr\/article-pdf\/19\/5\/714\/56475093\/5650190504.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,13]],"date-time":"2024-03-13T15:08:01Z","timestamp":1710342481000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jbmr\/article\/19\/5\/714-721\/7592825"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2004,5,1]]},"references-count":34,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2009,12,2]]},"published-print":{"date-parts":[[2004,5,1]]}},"URL":"https:\/\/doi.org\/10.1359\/jbmr.2004.19.5.714","relation":{},"ISSN":["0884-0431","1523-4681"],"issn-type":[{"value":"0884-0431","type":"print"},{"value":"1523-4681","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2004,5,1]]},"published":{"date-parts":[[2004,5,1]]}}}