Osteomalacia hipofosfatémica asociada al tenofovir en un paciente infectado por el VIH: un informe de caso

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Ayse Iyiyapici Unubol¹, Mustafa Unubol²

¹Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Aydın Adnan Menderes University, Aydin, TUR.

|February 10, 2026

Resumen

El fumarato de tenofovir disoproxil puede causar osteomalacia hipofosfatémica, una enfermedad ósea rara. El diagnóstico rápido y el tratamiento con suplementos de fosfato y vitamina D condujeron a una mejora significativa de los síntomas en un paciente.

Área de la Ciencia:

Nefrología Nefrología.
Endocrinología Endocrinología.
Reumatología Reumatología.

Sus antecedentes:

La osteomalacia hipofosfatémica es una enfermedad ósea metabólica rara en adultos.
A menudo se presenta con dolor y debilidad musculoesquelética, imitando condiciones reumatológicas.
El fumarato de tenofovir disoproxil (TDF), un medicamento para el VIH, rara vez puede inducir esta afección a través de la disfunción tubular renal proximal.

Objetivo del estudio:

Para reportar un caso de osteomalacia hipofosfatémica asociada con el TDF.
Para resaltar la importancia de considerar el TDF como una causa potencial de dolor óseo y muscular inexplicable.

Principales métodos:

Un informe de caso de un paciente varón de 33 años con dolor progresivo de huesos y músculos.
Investigaciones de laboratorio que incluyen fosfato sérico, fosfatasa alcalina y niveles de hormonas paratiroideas.
Evaluación clínica de los síntomas y la respuesta al tratamiento.

Principales resultados:

El paciente presentó hipofosfatemia severa, fosfaturia, elevación de la fosfatasa alcalina y la hormona paratiroidea.
La interrupción del TDF y el inicio de la suplementación con fosfato y vitamina D activa resultó en una mejora clínica y de laboratorio significativa.
Se confirmó el diagnóstico de osteomalacia hipofosfatémica asociada al tenofovir.

Conclusiones:

La osteomalacia hipofosfatémica es una complicación potencial, a menudo pasada por alto, de la terapia con TDF.
El reconocimiento y el manejo tempranos son cruciales para la recuperación del paciente.
Este caso subraya la necesidad de vigilancia en pacientes en TDF que experimentan síntomas relacionados con los huesos y los músculos.

Palabras clave:

El VIH y el SIDA.La osteomalacia hipofosfatémica también se conoce como osteomalacia hipofosfatémica.El túbulo renal proximal es el tubo renal proximal.La osteoporosis secundaria también es osteoporosis secundaria.El tenofovir disoproxil fumarato también se usa.

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