Tucci Joseph R, Whitford Gary M, McAlister William H, Novack Deborah V, Mumm Steven, Keaveny Tony M, Whyte Michael P
Department of Medicine, Roger Williams Medical Center, Providence, RI, USA.
Boston University School of Medicine, Boston, MA, USA.
J Bone Miner Res. 2017 Jan;32(1):188-195. doi: 10.1002/jbmr.2923. Epub 2016 Oct 14.
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.
骨氟中毒（SF）在许多国家呈地方性流行，全球数百万人受其影响，而在美国，骨氟中毒较为罕见，仅有个别独特病例的报道。我们报告了一名28岁的美国男性，他在两年前身体一直健康，之后逐渐出现行走困难、步态异常、左髋疼痛、右手腕和前臂活动受限以及包括双手手指增粗在内的进行性畸形。对其腰椎、股骨颈、全髋和三分之一前臂进行双能X线吸收测定（DXA）显示，骨矿物质密度（BMD）的Z值分别为+6.2、+4.8、+3.0和-0.2。血清、尿液和骨氟水平均升高，最终发现是由于长期吸入滥用一种含有1,1 - 二氟乙烷的电脑清洁剂所致。我们的研究结果反映了因吸入滥用二氟乙烷这一不寻常原因导致的骨氟中毒。由于这种行为似乎很普遍，尤其是在年轻人中，可能还有更多此类病例。© 2016美国骨与矿物质研究学会
