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Iatrogenic fluorosis.

D M Grennan, D G Palmer, R S Malthus

    Australian and New Zealand Journal of Medicine
    |October 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

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    High fluoride intake can cause bone issues like osteomalacia, even when taken with calcium. Careful monitoring is crucial for patients on fluoride therapy to prevent toxicity.

    Area of Science:

    • Endocrinology
    • Bone Metabolism
    • Toxicology

    Background:

    • Osteoporosis management often involves calcium and vitamin D supplementation.
    • Fluoride therapy has been explored for osteoporosis treatment.
    • Steroid-induced osteoporosis is a concern requiring therapeutic intervention.

    Observation:

    • A 69-year-old woman developed generalized bone pain after three years of treatment with sodium fluoride and calcium for osteoporosis.
    • Radiological and histological examination revealed osteosclerosis and osteomalacia, with high bone fluoride content.
    • The patient's condition was attributed to therapeutic fluoride dosage combined with calcium alone.

    Findings:

    • Therapeutic fluoride doses, when administered with calcium alone, can lead to fluorosis and osteomalacia.

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  • Bone biopsy confirmed histological changes indicative of osteomalacia.
  • Elevated bone fluoride levels were detected, correlating with the observed toxicity.

    • Implications:

    • This case highlights the potential toxicity of therapeutic fluoride, emphasizing the need for Vitamin D co-administration.
    • Careful clinical and biochemical monitoring is essential for patients receiving therapeutic fluoride dosages.
    • Current trial regimens for osteoporosis include fluoride with calcium and Vitamin D to mitigate osteomalacia risk.