The patient: A 28-year-old man in New England
The symptoms: For two years, the office worker had difficulty walking and developed an abnormal gait and hip pain. The bones in his hands also widened and he experienced reduced mobility in his right wrist and forearm.
What happened next: During an initial examination, doctors noted bony masses on each of the patient’s finger bones. He was later referred to specialists as the bones in his hands continued to develop. By then, he had developed a hunched posture and also walked with a lean to the left. The fluoride levels in his blood, urine and bones were all elevated.
The diagnosis: The patient was diagnosed with skeletal fluorosisa condition caused by long-term exposure to high levels of fluoride.
Exposure to safe levels of fluoride reduces the risk of tooth decayand fluoride is added to tap water in many countries around the world for this reason. However, when ingested in too large quantities, fluoride becomes a cumulative toxin that removes calcium from bones and thus alters their structure. Although bone density increases in the early stages of this disease, bones later they become brittle and less elastic.
After some research, the man’s doctors identified the likely source of his fluoride exposure. Fluoride levels in the man’s city water supply were at “acceptable levels,” his doctors noted. But they found a report of an older case who shared similar symptoms; in this case, the patient had inhaled canned “dust spray” used to clean computers. The doctors suspected that their patient was also sniffing aerosols and asked him if this was true. He admitted that he had been regularly snorting computer cleaner for more than three years to get high.
Difluoroethane, the active ingredient in many computer cleaners, is metabolized by the body into a fluorinated compound.
The treatment: The young man stopped abusing aerosols about five months after being examined. After another six months, his hip function had greatly improved and he could walk almost normally. The man first saw a doctor in 2010, and by 2014 he was walking better and exercising regularly. He stopped receiving medical care in 2015. Doctors concluded that stopping excessive fluoride consumption could gradually alleviate the symptoms of patients with skeletal fluorosis.
What makes the case unique: Skeletal fluorosis is a major problem in some countries, like Indiawhere natural sources of fluoride can cause fluoride levels in drinking water to be too high. However, this disease is very rare in the United States.
This case highlights a potentially overlooked cause of skeletal fluorosis: the cans of compressed air that people use to get high. THE authors of the case report I think there could be many other cases similar to this one.
This article is for informational purposes only and is not intended to offer medical advice.
