Unraveling Fanconi Syndrome: Severe Proximal Tubulopathy, Osteomalacia in a 27‐Year‐Old Male on TDF‐Based HIV Regimen: A Case Report

This case report delves into the complex presentation of Fanconi syndrome (FS) associated with tenofovir disoproxil fumarate (TDF) use in a 27‐year‐old male diagnosed with HIV. The patient exhibited severe proximal tubulopathy and osteomalacia, emphasizing the need for vigilant monitoring in individuals on TDF‐based regimens. The patient improved following withdrawal of TDF and substitution with a dolutegravir/abacavir/lamivudine‐based regimen, along with correction of metabolic acidosis, phosphate and vitamin D supplementation, and physiotherapy. Comprehensive clinical, laboratory, and radiological findings are discussed, shedding light on the challenges encountered during management and highlighting the significance of timely intervention. This case emphasizes the value of early recognition and prompt modification of therapy in drug‐induced FS.