Tenofovir as a Cause of Acquired Fanconi's Syndrome

Fanconi's syndrome is a disorder that results in generalized involvement of the proximal tubule of the kidney. It is characterized by variable degrees of phosphate, glucose, and amino acid wasting in the urine and a hyperchloremic normal anion gap metabolic acidosis – secondary to defective hydrogen ion excretion and bicarbonate ion absorption. There are hereditary variants such as cystinosis (most common), hereditary fructose intolerance, galactosemia, tyrosinemia, Dents disease, and acquired variants of Fanconi's syndrome. Toxins, drug-induced diseases, and systemic diseases (multiple myeloma, Sjogren's syndrome) are the most common acquired causes of Fanconi's syndrome. The case report describes a middle-aged female patient, a known case of human immunodeficiency virus (HIV)-positive status who developed tenofovir disoproxil fumarate-induced Fanconi's syndrome, an increasingly recognized cause of acquired Fanconi's syndrome in HIV-positive patients.