Skeletal Fluorosis Due To Inhalation Abuse of a Difluoroethane‐Containing Computer Cleaner

ABSTRACT Skeletal fluorosis (SF) is endemic in many countries and millions of people are affected worldwide, whereas in the United States SF is rare with occasional descriptions of unique cases. We report a 28‐year‐old American man who was healthy until 2 years earlier when he gradually experienced...

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Bibliographic Details
Published in:Journal of bone and mineral research 2017-01, Vol.32 (1), p.188-195
Main Authors: Tucci, Joseph R, Whitford, Gary M, McAlister, William H, Novack, Deborah V, Mumm, Steven, Keaveny, Tony M, Whyte, Michael P
Format: Article
Language:English
Subjects:
Adult
Bone Diseases - chemically induced
Bone Diseases - diagnostic imaging
Bone Diseases - pathology
Computers
Elbow - diagnostic imaging
Femur Neck - diagnostic imaging
Femur Neck - pathology
Finite Element Analysis
FLUORIDE
Humans
Hydrocarbons, Fluorinated
HYPEROSTOSIS
Inhalation Exposure - adverse effects
Male
OSTEOSCLEROSIS
Pelvis - diagnostic imaging
PERIOSTITIS
Tomography, X-Ray Computed
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Summary:ABSTRACT Skeletal fluorosis (SF) is endemic in many countries and millions of people are affected worldwide, whereas in the United States SF is rare with occasional descriptions of unique cases. We report a 28‐year‐old American man who was healthy until 2 years earlier when he gradually experienced difficulty walking and an abnormal gait, left hip pain, loss of mobility in his right wrist and forearm, and progressive deformities including enlargement of the digits of both hands. Dual‐energy X‐ray absorptiometry (DXA) of his lumbar spine, femoral neck, total hip, and the one‐third forearm revealed bone mineral density (BMD) Z‐scores of +6.2, +4.8, +3.0, and –0.2, respectively. Serum, urine, and bone fluoride levels were all elevated and ultimately explained by chronic sniffing abuse of a computer cleaner containing 1,1‐difluoroethane. Our findings reflect SF due to the unusual cause of inhalation abuse of difluoroethane. Because this practice seems widespread, particularly in the young, there may be many more such cases. © 2016 American Society for Bone and Mineral Research.
ISSN:0884-0431
1523-4681
DOI:10.1002/jbmr.2923