Skeletal Fluorosis from inhaling Computer Cleaner

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wendy
Posts: 46
Joined: Mon Apr 03, 2006 5:51 am

Skeletal Fluorosis from inhaling Computer Cleaner

Post by wendy »

Liane B, Chow A, Kline D - "Skeletal Fluorosis: An Unusual Manifestation of Computer Cleaner Inhalant Abuse" Cureus 12(6): e8461 (2020) doi:10.7759/cureus.8461 (June 5, 2020)
  • "Bone marrow histopathology revealed prominent diffuse sclerosis which in conjunction with urinary fluoride levels and computer cleaner inhalant abuse history supported the diagnosis of skeletal fluorosis. ...The serum fluoride level was within normal limits. Interestingly, urine fluoride was significantly elevated at 19 mg/L (ref. range: 0.2-3.2 mg/L) and the fluoride to creatinine ratio was significantly elevated (27.5 mg/g, upper limit of normal 3.0), rendering skeletal fluorosis the most likely diagnosis based on the patient’s history, presentation, imaging and laboratory findings".
SEE ALSO:

Tucci JR, Whitford GM, McAlister WH, Novack DV, Mumm S, Keaveny TM, Whyte MP - "Skeletal Fluorosis Due To Inhalation Abuse of a Difluoroethane-Containing Computer Cleaner" J Bone Miner Res 32(1):188-195 (2017) doi: 10.1002/jbmr.2923. Epub 2016 Oct 14. PMID: 27449958; PMCID: PMC5977397
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5977397/

Abstract
Skeletal fluorosis (SF) is endemic in many countries and millions of people are affected worldwide, whereas in the United States SF is rare with occasional descriptions of unique cases. We report a 28-year-old American man who was healthy until 2 years earlier when he gradually experienced difficulty walking and an abnormal gait, left hip pain, loss of mobility in his right wrist and forearm, and progressive deformities including enlargement of the digits of both hands. Dual-energy X-ray absorptiometry (DXA) of his lumbar spine, femoral neck, total hip, and the one-third forearm revealed bone mineral density (BMD) Z-scores of +6.2, +4.8, +3.0, and -0.2, respectively. Serum, urine, and bone fluoride levels were all elevated and ultimately explained by chronic sniffing abuse of a computer cleaner containing 1,1-difluoroethane. Our findings reflect SF due to the unusual cause of inhalation abuse of difluoroethane. Because this practice seems widespread, particularly in the young, there may be many more such cases. © 2016 American Society for Bone and Mineral Research.

Ed. Note: Interesting how Tucci, Whitford et al. once again downplay SF, stating that "it is rare" - although no one is looking for it, nor is familiar with the various stages of SF.
Last edited by wendy on Mon Nov 30, 2020 4:14 pm, edited 2 times in total.
wendy
Posts: 46
Joined: Mon Apr 03, 2006 5:51 am

More on difluoroethane

Post by wendy »

Ponce A, Oakes JA, Eggleston W - "Acute skeletal fluorosis in the setting of 1,1-difluoroethane abuse" Clin Toxicol (Phila) 57(5):374-375 (2019) doi: 10.1080/15563650.2018.1527034. Epub 2018 Nov 17. PMID: 30449202
https://pubmed.ncbi.nlm.nih.gov/30449202/

Cohen E, Hsu RY, Evangelista P, Aaron R, Rubin LE - "Rapid-Onset Diffuse Skeletal Fluorosis from Inhalant Abuse: A Case Report" JBJS Case Connect (2014) 4(4):e108. doi: 10.2106/JBJS.CC.N.00085. PMID: 29252776
https://pubmed.ncbi.nlm.nih.gov/29252776/

Calhoun K, Wattenbarger L, Burns E, Hatcher C, Patel A, Badam M, Khan AJ - "Inhaling Difluoroethane Computer Cleaner Resulting in Acute Kidney Injury and Chronic Kidney Disease" Case Rep Nephrol 2018:4627890 (2018) doi: 10.1155/2018/4627890. PMID: 29977633; PMCID: PMC6011111
https://pubmed.ncbi.nlm.nih.gov/29977633/

Peicher K, Maalouf NM - "Skeletal Fluorosis Due to Fluorocarbon Inhalation from an Air Dust Cleaner" Calcif Tissue Int 101(5):545-548 (2017)doi: 10.1007/s00223-017-0305-0. Epub 2017 Jul 20. PMID: 28725909
https://pubmed.ncbi.nlm.nih.gov/28725909/

Kumar S, Joginpally T, Kim D, Yadava M, Norgais K, Laird-Fick HS - "Cardiomyopathy from 1,1-Difluoroethane Inhalation" Cardiovasc Toxicol. 2016 Oct;16(4):370-3. doi: 10.1007/s12012-015-9348-5. PMID: 26613951
https://pubmed.ncbi.nlm.nih.gov/26613951/

Winston A, Kanzy A, Bachuwa G - "Air Duster abuse causing rapid airway compromise" BMJ Case Rep (2015) 2015:bcr2014207566. doi: 10.1136/bcr-2014-207566. PMID: 25568278; PMCID: PMC4289811
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289811/

Avella J, Wilson JC, Lehrer M - "Fatal cardiac arrhythmia after repeated exposure to 1,1-difluoroethane (DFE)" Am J Forensic Med Pathol 27(1):58-60 (2006) doi: 10.1097/01.paf.0000202715.71009.0e. PMID: 16501351
https://pubmed.ncbi.nlm.nih.gov/16501351/

Kurniali PC, Henry L, Kurl R, Meharg JV - "Inhalant abuse of computer cleaner manifested as angioedema" Am J Emerg Med 30(1):265.e3-5 (2012) doi: 10.1016/j.ajem.2010.12.003. Epub 2011 Feb 3. PMID: 21295430
https://pubmed.ncbi.nlm.nih.gov/21295430/

MORE
https://pubmed.ncbi.nlm.nih.gov/?term=d ... &sort=date
Last edited by wendy on Mon Nov 30, 2020 4:14 pm, edited 6 times in total.
wendy
Posts: 46
Joined: Mon Apr 03, 2006 5:51 am

Comment

Post by wendy »

What is of interest here, is the fact that this is a hydrofluorocarbon. For decades, the "experts" have maintained that HFCs have nothing to do with fluoride poisoning, as the fluorocarbon compounds are not metabolized info fluoride - apparently that is not true....

The National Institute on Drug Abuse reports that one in five American teens have used inhalants to get high (Winston et al., 2015).

Erntsgard et al., reported in 2012 that about 20 μmol excess fluoride (0.013% of inhaled 1,1-difluoroethane on a molar basis) was excreted in urine after exposure to 1000 ppm, compared to a control. NOTE: No trifluoroacetic acid metabolites found.

Ernstgård L, Sjögren B, Dekant W, Schmidt T, Johanson G - "Uptake and disposition of 1,1-difluoroethane (HFC-152a) in humans" Toxicol Lett 209(1):21-9 (2012) doi: 10.1016/j.toxlet.2011.11.028. Epub 2011 Dec 4. PMID: 22155657
https://www.researchgate.net/publicatio ... ns/figures

"Thus, the modeled relative uptake as well as the net uptake was about 30% higher in men, whereas the AUC and maximum concentration in blood (C120) were between 7% and 16%higher in women."
Last edited by wendy on Mon Nov 30, 2020 4:14 pm, edited 3 times in total.
wendy
Posts: 46
Joined: Mon Apr 03, 2006 5:51 am

Halothane

Post by wendy »

"The complete metabolic fate of the volatile anesthetic halothane is unclear since 2-chloro-1,1-diflurorethene (CDE), a reductive halothane metabolite, is known to readily release inorganic fluoride upon oxidation by cytochrome P-450."

Baker MT, Vasquez MT, Bates JN, Chiang CK - "Metabolism of 2-chloro-1,1-difluoroethene to glyoxylic and glycolic acid in rat hepatic microsomes" Drug Metab Dispos 18(5):753-8 (1990) PMID: 1981732
https://pubmed.ncbi.nlm.nih.gov/1981732/
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