Fanconi Syndrome and Lactic Acidosis Associated with Stavudine and Lamivudine Therapy

Nelson Mark, Chelsea and Westminster Hospital, London, UK
Azwa Alex, Chelsea and Westminster Hospital, London, UK
Ahmed Sokwala, Aga Khan University
Reena Shah, Aga Khan University
Stebbing Justin, Chelsea and Westminster Hospital, London, UK

Abstract

We report a case of the nucleoside reverse transcriptase inhibitors, stavudine and lamivudine inducing Fanconi syndrome in a patient. The presence of simultaneous lactic acidosis suggests mitochondrial toxicity within the proximal renal tubular cells as the likely pathogenesis. We recommend that both the above nucleosides be added to the list of antiretroviral drugs that can induce Fanconi syndrome and that patients on stavudine and lamivudine be monitored carefully for early signs of Fanconi syndrome.