Bone disease and pathologic fractures in a patient with tenofovir-induced Fanconi syndrome.

We report the case of an HIV-positive patient with preexisting bone disease who developed tenofovir-induced Fanconi syndrome and subsequently sustained pathologic fractures. We suggest that tenofovir treatment may have contributed to the patient's pathologic fractures through its effects on phosphorus balance and vitamin D metabolism. This case highlights the importance of monitoring not only for renal impairment but also for bone disease in patients receiving tenofovir treatment, especially given the high prevalence of osteopenia and osteoporosis in HIV-positive patients.