Histopathological assessment of endemic skeletal fluorosis
Faccini, J.M.; Teotia, S.P.
Calcified Tissue Research 16(1): 45-57
1974
ISSN/ISBN: 0008-0594 PMID: 4447889 Document Number: 76410
Nine patients with skeletal fluorosis were subjected to iliac crest biopsy because they presented with stiffness and bone pains. The histopathological findings are correlated with the clinical course, X-ray and laboratory data. All but 1 of the patients showed an increase in bone surfaces lined by osteoid and in these 8 patients resorption of bone was the most striking finding and in 1 the bone marrow was predominantly fibrous. The severity of radiological and histological bone changes appeared to increase with the duration of exposure to fluoride in most cases. The increase in resorption surfaces correlated, positively, with plasma alkaline phosphatase, bone F and the radiological findings of coarse striated patterns and erosions in the bone. The histopathological picture was not related to plasma Ca and the urinary excretion of Ca and F. The concentration of F in the iliac crest biopsies was related to the degree of bone resorption in most and the highest in these patients was in the one who had stayed longest in the endemic fluorosis area. New bone formation and osteoclastic resorption were probably caused by increased action of parathyroid hormone secondary to the fluorosis. The hyperfunction of the parathyroid glands developed as a compensatory phenomenon to maintain plasma Ca in the presence of the fluoroapatite crystals which are known to be less soluble and less reactive.