Fluoride-related bone disease associated with habitual tea consumption
Fluoride-related bone disease associated with habitual tea consumption
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DOI：
10.4065/82.6.719
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发表时间：
2007-06-01
影响因子：
8.9
通讯作者：
Wermers, Robert A.
中科院分区：
文献类型：
--
作者：
Johnson, Julie E. Hallanger;Kearns, Ann E.;Wermers, Robert A.
获得性骨质疏松症是一种罕见的骨形成疾病，但在成年人中，骨质疏松或骨密度升高是一个重要的考虑因素。在这类患者中，诊断时应考虑恶性肿瘤、丙型肝炎和氟中毒。我们描述了4例患者在我们的代谢性骨病诊所从1997年5月IL，2006年7月1日，其骨骼疾病导致慢性氟暴露，由于过量的茶摄入。其中3名患者血清氟中毒（>15 μ mol/L）。尽管患者的临床表现各不相同，但所有4例患者的脊柱骨密度均意外升高，比例高于髋关节骨密度。其他临床特征包括胃肠道症状，如恶心、呕吐和体重减轻;下肢疼痛，有时与下肢应力性骨折相关;肾功能不全;碱性磷酸酶水平升高。茶叶容易获得，通常含有高水平的氟化物。强迫性饮酒行为和肾功能不全可能导致过量的氟消耗和积累。目前的病例表明，氟相关性骨病是骨密度高或有胃肠道症状和过量饮茶史的患者的重要临床考虑因素。此外，所有有过量饮茶史的患者都应考虑氟过量，特别是由于其潜在的性质和非特异性的临床表现。
Acquired osteosclerosis is a rare disorder of bone formation but an important consideration in adults with sclerotic bones or elevated bone density results. In such patients, malignancy, hepatitis C, and fluorosis should all be considered when making a diagnosis. We describe 4 patients evaluated at our Metabolic Bone Disease Clinic from May IL, 1997, to July 1, 2006, whose bone disorders resulted from chronic fluoride exposure due to excessive tea intake. Three of these patients had toxic serum fluoride levels (>15 [mu mol/L.). Although the clinical presentation of the patients varied, all 4 had an unexpectedly elevated spine bone mineral density that was proportionately higher than the bone mineral density at the hip. Other clinical features included gastrointestinal symptoms such as nausea, vomiting, and weight loss; lower extremity pain sometimes associated with stress fractures of the lower extremities; renal insufficiency; and elevated alkaline phosphatase levels. Readily available, tea often contains high levels of fluoride. Obsessive-compulsive drinking behaviors and renal insufficiency may predispose to excessive fluoride consumption and accumulation. The current cases show that fluoride-related bone disease Is an important clinical consideration in patients with dense bones or gastrointestinal symptoms and a history of excessive tea consumption. Furthermore, fluoride excess should be considered in all patients with a history of excessive tea consumption, especially due to Its insidious nature and nonspecific clinical presentation.