Abstract: A case of 60-year-old male patient with chronic hepatitis B was admitted for hepatic dysfunction
caused by irregular use of antiviral drugs. He began to restart the antiviral therapy regularly with ETV 0.5
mg QN from July 7, 2016. Since there was no improvement of liver function during the monitoring, the total
bilirubin was rising; the maximum value was up to 207.2 μmol/L, and PTA was declining; the minimum
value arrived at 53%. Therefore, the dose of ETV was changed to 1 mg QN from July 20. On August 4, the
patient began to occur muscle weakness, muscle pain and other uncomfortable symptoms, and the laboratory
test showed myoglobin＞ 1200 ng/ml, the creatine kinase was 41940 U/L, the aspertate aminotransferase
was 1171 U/L. Routine urine: pH = 7.00, BLD+++ 300 cell/ml, RBC 36.75 p/HPF, the head CT scan was
normal. Entecavir induced rhabdomyolysis was considered. So the dose of entecavir was adjusted to 0.5 mg,
and the patient was treated with high dose of hydration, and alkalize urine therapy was used as well. Then the
patient’s muscle symptoms recovered, and the myoglobin, creatine kinase returned to normal.