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

J Bone Miner Res. 2017 Jan;32(1):188-195. doi: 10.1002/jbmr.2923. Epub 2016 Oct 14.

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.

Keywords: FLUORIDE; HYPEROSTOSIS; OSTEOSCLEROSIS; PERIOSTITIS.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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
  • Humans
  • Hydrocarbons, Fluorinated
  • Inhalation Exposure / adverse effects*
  • Male
  • Pelvis / diagnostic imaging
  • Tomography, X-Ray Computed

Substances

  • Hydrocarbons, Fluorinated
  • 1,1-difluoroethane