Clinical features of adverse reactions associated with telbivudine

Table 1 General information and medication status

Case	Age (yr)	Hepatitis history (yr)	Current diagnosis	Medication history	Telbivudine		Drug and time combined
					Dosage	Time (mo)
1	45	10	Hepatocirrhosis	DLAM, ECV	600 mg bid	2	-
					600 mg qd	5	ADV for 5 mo
2	35	6	Hepatitis B	LAM, ADV	600 mg qd	7	Interferon for 3 mo
3	37	37	Hepatitis B	LAM, ADV	600 mg qd	1	-
4	30	1	Hepatitis B	-	600 mg qd	7	Interferon for 3 mo
5	25	2	Hepatitis B	ADV	600 mg qd	9	Interferon for 3 mo

LAM: Lamivudine; ADV: Adefovir; ECV: Entecavir.

Table 2 Clinical symptoms of telbivudine-related adverse reactions

Case	Occurred time (mo)	Injured location	Soreness		Weakness		Numbness		Neuralgia		Cardiac arrhythmia
			Take	Stop	Take	Stop	Take	Stop	Take	Stop	Take	Stop
1	1.5	Shoulder	+		++		-		-		-
	2	Limb	+	-	+	-	-	-	-	-	-	-
2	5	Limb	++	+	++	+	++	+	++	+	-	-
3	0.5	Limb	++	-	++	+	++	+	-	-	++	+
4	2	Limb	+	-	+	-	++	+	-	-	-	-
5	1	Buttock	++	+	++	+	++	+	-	-		-

++: Very serious; +: Serious; -: Not serious.

Table 3 Blood tests results

Case	Muscle enzymes		Liver function			Blood counts		Kidney function
	CK (IU/L)	LDH (IU/L)	ALT (IU/L)	AST (IU/L)	GGT (IU/L)	WBC (× 109/L)	HGB (g/L)	PLT (× 109/L)	BUN (mmol/L)	CR (&mgr;mol/L)
1	438.7	182.9	97.3	216.4	115.8	4.28	144	39	3.91	101
2	900	-	32.1	31.3	24.8	2.7	130	118	2.53	107
3	191	117	32	24	26	7.19	153	212	8.38	100
4	311	253	50	47	117	3.6	147	86	4.60	45
5	400.2	424.8	92.9	68.3	21.6	3.4	133	154	-	-

Table 4 Diagnosis process

Case	Confirmed time	Misdiagnosis	Examinations	Medication
1	1 d	Arthritis	No	Paste for arthritis
	2 d	Myocarditis	Cardiac enzymes	-
2	3 mo	Neuritis, arthritis	Lumber spinal MRI, laboratory examination	Vitamin B
3	0.5 mo	Neuritis, myocarditis	Myozyme, holter, ECG, ultrasoundcardiography	Mecobalamin, propafenone
4	1 d	-	-	-
5	2 mo	Neuritis	-	Vitamin B