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[2例类风湿关节炎患者因长期服用尼氟灭酸导致氟骨症]

[Fluorine osteosis caused by a very long-term niflumic acid treatment in 2 cases of rheumatoid arthritis].

作者信息

Prost A, Boiteau H L, Gaillard F, Hamelin J P, Carlier N, Rossel-Renac F

出版信息

Rev Rhum Mal Osteoartic. 1978 Dec;45(12):707-16.

PMID:107572
Abstract

An osteosclerosis opacifying the axial skeleton and affecting in particular all of the spine, was observed in two women aged 75 and 42 years who had been suffering from a rheumatoid arthritis developing between 15 and 26 years. It was traced to a chronic fluorine intoxication, stemming from the regular taking, for 10 years and 8 1/2 years, of a non cortisone, anti-inflammatory niflumic acid. This fluorine product has 3 atoms of fluor in its molecule (50.0 mg for a tablet of 250 mg). Its administration to control subjects proved the production of ionized fluor by way of the metabolism, and the accumulation of fluor in the organism. Rheumatoid polyarthritis and the prolonged corticotherapy (10 mg of prednisone per day for 21 years) cannot be dismissed as the origin of the severe demineralization of the limbs observed in the second patient, but the role of fluorine seems marked in the occurrence of this peripheral involvement with problems of mineralization and secondary hyperparathyroidisms. On the other hand, the absence of an intervertebral narrowing in the 2 patients, despite the very prolonged taking of cortisone (5 mg of prednisone per day for 15 years, for the 75-year-old patient) is perhaps a result of the fluorine.

摘要

在两名分别为75岁和42岁的女性中观察到一种骨硬化,其使中轴骨骼浑浊,尤其影响整个脊柱。这两名女性患有类风湿关节炎,病程在15至26年之间。病因追溯为慢性氟中毒,源于她们分别持续服用非皮质类固醇抗炎药尼氟酸10年和8年半。这种含氟产品分子中有3个氟原子(每250毫克片剂含50.0毫克氟)。对对照受试者给药证实,该药物经代谢产生离子氟,并在体内蓄积。类风湿性多关节炎以及长期皮质激素治疗(第二名患者每天服用10毫克泼尼松,持续21年)不能排除是第二名患者出现严重肢体脱矿质的原因,但氟在这种伴有矿化问题和继发性甲状旁腺功能亢进的外周病变发生中似乎起显著作用。另一方面,尽管两名患者长期服用皮质激素(75岁患者每天服用5毫克泼尼松,持续15年),但未出现椎间变窄,这可能是氟的作用结果。

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