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Fatal lactic acidosis in hepatitis B virus-associated decompensated cirrhosis treated with tenofovir A case report

Title
Fatal lactic acidosis in hepatitis B virus-associated decompensated cirrhosis treated with tenofovir A case report
Author
전대원
Keywords
HBV; lactic acidosis; tenofovir disoproxil fumarate
Issue Date
2017-09
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
MEDICINE, v. 96, no. 25, Article no. e7133
Abstract
Rationale: Recently tenofovir disoproxil fumarate (TDF) has been widely used as a first-line therapy for chronic hepatitis B (CHB) infection. Although TDF demonstrates successful viral suppression, the possibility of renal failure and lactic acidosis has been proposed with TDF administration, especially in human immunodeficiency virus co-infected patients. However, TDF induced lactic acidosis has never been reported in CHB mono-infected patients.Patient concerns: A 59-year-old man received TDF for hepatitis B associated with cirrhosis. After ten days of TDF administration, nausea, vomiting and abdominal pain developed. High anion gap acidosis with elevated lactate level (pH 7.341, pCO(2) 29.7 mmHg, HCO3-15.6mmHg, lactate 3.2mmol/L, anion gap 15.4 mEq/L) was developed.Diagnosis: With no infection, normal diagnostic paracentesis, and urinalysis together with high anion gap and increased blood lactate levels suggested lactic acidosis.Interventions: TDF was stopped, and haemodialysis was performed to control lactic acidosis.Outcomes: Although stopping TDF instantly and treating lactic acidosis using hemodialysis, the patient died.Lessons: Although, Fatal lactic acidosis is very rare in TDF patient, however, decompensated cirrhotic patients should be closely observed to keep the possibility of lactic acidosis in mind.
URI
https://insights.ovid.com/crossref?an=00005792-201706230-00016https://repository.hanyang.ac.kr/handle/20.500.11754/115678
ISSN
0025-7974; 1536-5964
DOI
10.1097/MD.0000000000007133
Appears in Collections:
COLLEGE OF MEDICINE[S](의과대학) > MEDICINE(의학과) > Articles
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