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Induction of Skeletal Fluorosis in Two Common Demineralizing Disorders

Phin Cohen, MD; Frank H. Gardner, MD
JAMA. 1966;195(11):962-963. doi:10.1001/jama.1966.03100110130044.
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THE COMBINATION of fluoride, calcium, and androgen therapy has been shown to induce radiologically obvious fluorosis in four cases of multiple myeloma.1 The purpose of this report is to show that fluorosis may be induced in two other common types of osteoporosis.

Report of Cases 

CASE 1.—  A 59-year-old woman with classical rheumatoid arthritis was seen in 1950. During the next nine years she was treated in another clinic with daily doses of corticosteroids with good control of joint symptoms. In 1959 severe thrombocytopenia developed which was unresponsive to corticosteroids. Splenectomy resulted only in a brief remission, and treatment with prednisone was continued at a dose of 15 mg daily. In 1962, because of severe back pain with vertebral (Fig 1, top left) and pelvic (Fig 1, bottom left) osteoporosis, the prednisone was reduced to 7.5 mg/day and treatment with azathioprine was started at 150 mg/day. This program controlled


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