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Published on: March 29, 2018
Skeletal fluorosis secondary to harmful inhalant use
Derek J Fikse1, Danny Le2, Ryan M Surmaitis1
1Department of Emergency and Hospital Medicine, Division of Medical Toxicology, Lehigh Valley Health Network/USF Morsani College of Medicine, Allentown, PA, USA.
Introduction:
Inhalants are common household items that may be abused for the desired effect of euphoria. Skeletal fluorosis is an uncommon and debilitating bone disorder caused by excess fluoride deposition. We report a case of skeletal fluorosis from chronic inhalation of an electronic duster product containing 1,1-difluoroethane.
Case:
A 33-year-old male with inhalant use disorder presented to the emergency department with prominent bilateral hand swelling and long bone deformities. The patient reported five years of inhaling "surf onn.© electronic duster" (1,1-Difluoroethane). Diagnostic testing demonstrated urine fluoride 64.5 mg/L (ref <3) and serum fluoride 1.8 mg/L (ref <0.13). Radiographs demonstrated diffuse periosteal new bone formation and sclerosis consistent with skeletal fluorosis.
Conclusion:
Skeletal fluorosis is an uncommon complication of inhalant use disorder with products containing fluoride.
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