Tenofovir Induced Bilateral Femoral Neck Stress Fracture


Authors : Sourabh N Chiplunkar; Harsharaj K

Volume/Issue : Volume 9 - 2024, Issue 7 - July

Google Scholar : https://tinyurl.com/44n3zjcr

Scribd : https://tinyurl.com/s49bwrwr

DOI : https://doi.org/10.38124/ijisrt/IJISRT24JUL972

Abstract : Case: A 47 year old male, came with history of bilateral hip pain ,insidious in onset gradually progressive, with difficulty in walking unassisted since 2 years. No history of fall/ trauma. Patient is known case of retroviral disease and on ART (TLE regimen ) since 2 years. Relevant radiographs were done and was diagnosed with bilateral neck of femur stress fracture (Tenofovir induced) associated with hypophosphatemia. ART regimen was changed to (Abacavir ,Lamivudine , Dolutegravir) . Patient on regular follow up every 2 months with serial radiographs. . On 6 months follow up patient is symptomatically improved with healing bilateral neck of femur stress fracture.

Keywords : Tenofovir, Stress Fracture , ART.

References :

  1. Atypical femoral neck stress fracture in a human immunodeficiency virus-infected patient despite anti-osteoporotic treatment:  A case report Rana Terlemez1 , Mehmet Mesut Sönmez2 , Aziz Ahmad Hamidi, Figen Yılmaz
  2. Looker AC, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, et al. Updated data on proximal femur bone mineral levels of US adults Osteoporos Int 1998 8 468 89
  3. Tebas P, Powderly WG, Claxton S, Marin D, Tantisiriwat W, Teitelbaum SL, et al. Accelerated bone mineral loss in HIV-infected patients receiving potent antiretroviral therapy AIDS 2000 14 F63 7
  4. Triant VA, Brown TT, Lee H, Grinspoon SK Fracture prevalence among human immunodeficiency virus (HIV)-infected versus non-HIV-infected patients in a large U.S. healthcare system J Clin Endocrinol Metab 2008 93 3499 504
  5. Womack JA, Goulet JL, Gibert C, Brandt C, Chang CC, Gulanski B, et al. Increased risk of fragility fractures among HIV infected compared to uninfected male veterans PLoS One 2011 6 e17217
  1. McDermott AY, Terrin N, Wanke C, Skinner S, Tchetgen E, Shevitz AH CD4+cell count, viral load, and highly active antiretroviral therapy use are independent predictors of body composition alterations in HIV-infected adults: A longitudinal study Clin Infect Dis 2005 41 1662 70
  2. Brown TT, Mallon PW. Editorial: Working towards an understanding of bone disease in HIV. Curr Opin HIV AIDS. 2016;11:251–252.
  3. de Menezes EG, Machado AA, Barbosa F Jr, de Paula FJ, Navarro AM. Bone metabolism dysfunction mediated by the increase of proinflammatory cytokines in chronic HIV infection. J Bone Miner Metab. 2017;35:234–242. 

Case: A 47 year old male, came with history of bilateral hip pain ,insidious in onset gradually progressive, with difficulty in walking unassisted since 2 years. No history of fall/ trauma. Patient is known case of retroviral disease and on ART (TLE regimen ) since 2 years. Relevant radiographs were done and was diagnosed with bilateral neck of femur stress fracture (Tenofovir induced) associated with hypophosphatemia. ART regimen was changed to (Abacavir ,Lamivudine , Dolutegravir) . Patient on regular follow up every 2 months with serial radiographs. . On 6 months follow up patient is symptomatically improved with healing bilateral neck of femur stress fracture.

Keywords : Tenofovir, Stress Fracture , ART.

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