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Chapter-076 Fluorosis

BOOK TITLE: ESI Manual of Clinical Endocrinology

Author
1. Harinarayan CV
ISBN
9789351526476
DOI
10.5005/jp/books/12535_95
Edition
2/e
Publishing Year
2015
Pages
5
Author Affiliations
1. Sri Venkateswara Institute of Medical Sciences, Tirupati, Andhra Pradesh, India, Institute of Endocrinology, Diabetes and Osteoporosis, Sakra World Hospitals, (next to Passport office), (A kirloskar + Toyota Tsusho + Secom Hospitals Joint Venture), Deverabeesanahalli, (opp Intel, Outer Ring Road), Varathur Hobili, Marathahalli, Bengaluru, Karnataka, India
Chapter keywords
Fluorosis, parametabolic bone, hyperparathyroidism, Osteorenal syndrome, interosseous bone, osteosclerosis

Abstract

Fluoride is the most potent electronegative element found on earth. Fluorosis is parametabolic bone crippling and throbbing disease caused by an intake of fluoride. The secondary hyperparathyroidism that sets in stimulates the osteoblast with ensuing bone resorption to normalize the serum calcium. Fluoride intoxication plays a key role in the pathogenesis of the unique osteorenal syndrome. Autopsy findings in one patient who died of azotemia showed tubular atrophy with secondary glomerular changes. Dental fluorosis is a clinical index of the epidemiology of fluorosis. The usual radiological features are generalized osteosclerosis of the axial and appendicular skeleton, uneven periosteal bone formation, calcification of interosseous bone membranes, muscle attachment, capsules and tendons. Bone scanning using TC-MDP (diphosphonate) scanning reveals comprehensive increased uptake of the skeleton. When the FMBD patients were compared with the control population, there was a major increase in osteoid volume, surface, and thickness in FMBD. Clinical recovery occurs in patients when disclosure to fluoride ceases and treated with calcium and vitamin D.

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