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Table 1 The timeline of the patient’s medical history and interventions

From: Case report: lactic acidosis and rhabdomyolysis during telbivudine and tenofovir treatment for chronic hepatitis B

Dates

Summaries

Diagnostic Testing

Interventions

2002

Found HBV infection

HBsAg, HBeAg, HBcAb positive

No antiviral treatment

2013

Diagnosed with cirrhosis

HBV DNA: 6.5*103 copies/ml

Telbivudine

2013-2015.9

 

HBV DNA undetected

Telbivudine

2015.9

 

HBV DNA: 7*103 copies/ml

Telbivudine and Tenofovir

2015.9-2015.10

Myalgia and hypoesthesia in both lower limbs

 

Telbivudine and Tenofovir

2015.10

Myalgia and hypoesthesia not relieved

 

Adefovir

2015.11.17

Myalgia and hypoesthesia not relieved

ALT 66 U/L, LDH 474 U/L, CPK 1050 U/L

Adefovir; liver-protecting treatment

2015.11.25

Myalgia and hypoesthesia not relieved; Chest tightness and short of breath occurred

Blood lactate 12.7 mmol/L, arterial blood gas: pH 7.25, base excess −21.1 mmol/L

Adefovir; liver-protecting treatment

2015.11.27

(Admission)

Myalgia, hypoesthesia, chest tightness, short of breath, palpitation; Swelling and tenderness of all extremities, muscle dumbness and grade 3 strength in both lower limbs

ALT: 77 U/L, TBil: 25.2 μmol/L, CPK: 991 U/L, LDH: 509 U/L, creatine: 83 μmol/L, myoglobin: 1745 ng/ml, blood lactate: 20 mmol/L,

HBV DNA undetected

Entecavir; hemodialysis; hydration; alkalization

2015.12.4

Nearly all symptoms relieved gradually

CPK 683 U/L, blood lactate 6.67 mmol/L

Tenofovir, Methylprednisolone 40 mg qd

2016.1.13

Swelling of lower limbs disappeared

CPK 47 U/L, blood lactate 3.21 mmol/L

Tenofovir

2016.6

Walk naturally; Dumbness in distal limbs relieved but still existed

HBV undetected

Tenofovir

  1. HBV Hepatitis B virus, HBsAg Hepatitis B surface Antigen, HBeAg Hepatitis B envelope Antigen, HBcAb Hepatitis B core Antibody, ALT Alanine aminotransferase, LDH Lactate dehydrogenase, CPK Creatine phosphokinase, TBil Total Bilirubin