Development of osteomalacia in a post-liver transplant patient receiving adefovir dipivoxil

Figure 1 Whole body bone scintigraphy shows multiple foci of increased radiotracer uptake in the thoracic spine, the sacroiliac region, the rib cage, the shoulders, the knees, and the ankles.

Figure 2 Clinical course of the present case. After switching from ADV plus LAM to ETV, serum levels of P and ALP improved, and the patient’s bone pain also decreased dramatically. ADV: adefovir dipivoxil; LAM: lamivudine; ETV: entecavir hydrate; PSL: prednisolone; P: phosphate; APL: alkaline phosphatase; γ-GTP: γ-glutamyl transferase; LDLT: living donor-related liver transplantation.