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Skeletal Fluorosis Due To Inhalation Abuse of a Difluoroethane‐Containing Computer Cleaner
Author(s) -
Tucci Joseph R,
Whitford Gary M,
McAlister William H,
Novack Deborah V,
Mumm Steven,
Keaveny Tony M,
Whyte Michael P
Publication year - 2017
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.2923
Subject(s) - inhalation , medicine , environmental health , dentistry , anesthesia
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.