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

Area of Science:

• Endocrinology
• Toxicology
• Orthopedics

Background:

• Skeletal fluorosis (SF) is a debilitating bone disease prevalent globally, yet rarely documented in the United States.
• Typical causes of SF involve chronic ingestion of high-fluoride water or industrial exposure.
• This report details an atypical presentation of SF in an American patient.

Purpose of the Study:

• To report a unique case of skeletal fluorosis in the United States.
• To identify an unusual etiology for fluoride toxicity.
• To raise awareness of potential widespread cases due to inhalant abuse.

Main Methods:

• Clinical presentation and medical history of a 28-year-old male patient.
• Diagnostic imaging including Dual-energy X-ray absorptiometry (DXA) for bone mineral density (BMD).
• Biochemical analysis of serum, urine, and bone fluoride levels.

Main Results:

• The patient exhibited progressive difficulty walking, hip pain, reduced wrist mobility, and digit deformities.
• DXA revealed significantly elevated BMD Z-scores in the lumbar spine, femoral neck, and total hip.
• Elevated fluoride levels in serum, urine, and bone confirmed skeletal fluorosis, linked to chronic inhalation abuse of 1,1-difluoroethane-containing computer cleaner.

Conclusions:

• This case demonstrates skeletal fluorosis resulting from the novel route of inhalant abuse of 1,1-difluoroethane.
• The practice of inhaling such substances may be more common, especially among younger populations.
• Increased recognition of this exposure route is crucial for diagnosing and preventing SF in similar cases.