GASTRODUODENAL MANIFESTATIONS IN PATIENTS WITH SKELETAL FLUOROSIS

A prospective case-controlled study was performed to evaluate the gast rointestinal symptoms and mucosal abnormalities occurring in patients with osteofluorosis. Ten patients with documented osteofluorosis and t en age- and sex-matched healthy volunteers were included in the study. Clinical evaluation, real-time ultrasound, and upper gastrointestinal endoscopy and biopsy from the gastric antrum and duodenum were perfor med in all subjects. The biopsies were subjected to a rapid urease tes t and light and electron microscopic examinations. Ionic fluoride leve ls were estimated in the drinking water, serum, and urine using an ION 85 ion analyzer. All patients with osteofluorosis had gastrointestina l symptoms, the most common being abdominal pain. Endoscopic abnormali ties were found in seven patients with osteofluorosis. In all 7 of the se patients, chronic atrophic gastritis was seen on histology. Electro n microscopic abnormalities were observed in all 10 patients with oste ofluorosis. These included loss of microvilli, cracked-clay appearance , and the presence of surface abrasions on the mucosal cells. None of the control subjects had any clinical symptoms or mucosal abnormalitie s. It was concluded that gastrointestinal symptoms as well as mucosal abnormalities are common in patients with osteofluorosis.