AB0984 Cadmium toxicity as a probable cause of smoking induced bone loss

Elbeialy, Adel; Eldosouky, H.A.

doi:10.1136/annrheumdis-2018-eular.3369

Cited by 3 publications

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“…We attributed this chronic vitamin D3 de ciency or insu ciency to probable long term exposure to pollutants, as the heavy metals cadmium and lead, present in some mineral waters, zzy waters, fried snacks, and tobacco smoke. [7,8,29].…”

Section: Discussionmentioning

confidence: 99%

Middle East Pain Syndrome (MEPS) Vitamin D3 Deficiency Induced Hyperparathyroidism and Fibromyalgia Mimicking Rheumatoid Arthritis

et al. 2021

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Objectives: Musculoskeletal pains are sometimes misdiagnosed in some diseases, like rheumatoid and psoriatic arthritis, erosive OA, etc. Secondary hyperparathyroidism was not considered a differential diagnosis for RA, despite the fact that it can cause arthralgia or arthritis. Also, bromyalgia is a psychosomatic condition marked by widespread pain and tenderness.Methods: This study included 400 patients attended outpatient clinics of Al-Azhar Faculty of medicine in Egypt, and Elaj Specialized Clinics in Saudi Arabia, who were not ful lling criteria for RA diagnosis, and not responding to its treatment. Other diseases like psoriatic arthritis and erosive OA were excluded.Criteria for classi cation of bromyalgia syndrome were applied to all patients. We did lab tests of RF, ACPA, ESR, CRP, LFT, RFT, vitamin D3, PTH, calcium, phosphorus, and SUA. Radiological imaging modalities for diagnosis or exclusion of suspected diseases were applied.Results: All patients were ful lling both old and new criteria of bromyalgia syndrome, and not ful lling any RA criteria, 18% were seropositive with low RF titers and negative ACPA. All patients had vitamin D3 de ciency or insu ciency. 75% of patients had abnormally high levels of PTH, and had no parathyroid gland pathology. X-rays showed subperiosteal and subchondral resorption of mainly thumbs, subchondral osteopenia of proximal and middle phalanges, mild subperiosteal resorption along the radial aspect of the middle phalanx and mild tuft erosions, besides changes in the carpus closely resembling those of rheumatoid arthritis, of ulnar styloid resorption, radiocarpal and scapho-trapezoid joint arthritis.Of special interest, the presence of tuft spurs-like excrescences.

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Section: Discussionmentioning

confidence: 99%

Middle East Pain Syndrome (MEPS) Vitamin D3 Deficiency Induced Hyperparathyroidism and Fibromyalgia Mimicking Rheumatoid Arthritis

et al. 2021

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“…Of course, secondary hyperparathyroidism in our patients is caused by a series of chronic vitamin D3 shortage, and is not caused by renal issues, malignancies, or other reasons. This chronic vitamin D3 shortage was ascribed to possible long-term exposure to the heavy metal cadmium, which is found in some mineral waters, carbonated beverages, fried foods, and tobacco smoke 16 .…”

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confidence: 99%

Commentary on: Middle East Pain Syndrome is A Pollution-Induced New Disease Mimicking Rheumatoid Arthritis

Elbeialy¹,

Bauomi²,

Elnaggar³

et al. 2022

J Orthopedics & Orthopedic Surg

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Middle East Pain Syndrome (MEPS) is a newly discovered disease, which may be one of the consequences of environmental pollution with heavy metals such as cadmium. It was named so, because all of the patients were from the Middle East, though it might affect people all over the world.This syndrome comprises a chronic vitamin D3 deficiency or insufficiency, secondary hyperparathyroidism, and fibromyalgia.Hyperparathyroidism was first linked to arthritis in (1963) 1 , and then in (1983). Arthritis was found in 11% of hyperparathyroid (HPT) patients, with incidences of erosive arthritis 2 . Other case studies 2-6 had also described HPT presenting as arthritis. Meanwhile, HPT can coexist with inflammatory arthritis such as rheumatoid arthritis on rare occasions 7 .

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Middle east pain syndrome is a pollution-induced new disease mimicking rheumatoid arthritis

Elbeialy

Bauomi

Elnaggar

et al. 2021

Sci Rep

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Musculoskeletal pains are sometimes misdiagnosed in some diseases, like rheumatoid and psoriatic arthritis, erosive OA, etc. Secondary hyperparathyroidism was not considered a differential diagnosis for RA, despite the fact that it can cause arthralgia or arthritis. Also, fibromyalgia is a psychosomatic condition marked by widespread pain and tenderness. This study included 400 patients attended certain outpatient clinics of Rheumatology in Egypt and Saudi Arabia, who were not fulfilling criteria for RA diagnosis. Criteria for classification of fibromyalgia syndrome were applied to all patients. We did lab tests and radiological imaging modalities for diagnosis or exclusion of suspected diseases were applied. All patients were fulfilling both old and new criteria of fibromyalgia syndrome, and not fulfilling any RA criteria, and had vitamin D3 deficiency or insufficiency. 75% of patients had abnormally high levels of PTH, without parathyroid gland pathology. Radiology showed subperiosteal and subchondral resorption of mainly thumbs, subchondral osteopenia of proximal and middle phalanges, mild subperiosteal resorption along the radial aspect of the middle phalanx and mild tuft erosions, besides changes in the carpus closely resembling those of rheumatoid arthritis, of ulnar styloid resorption, radiocarpal and scapho-trapezoid joint arthritis. Of special interest, the presence of tuft spur-like excrescences.

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AB0984 Cadmium toxicity as a probable cause of smoking induced bone loss

Cited by 3 publications

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Middle East Pain Syndrome (MEPS) Vitamin D3 Deficiency Induced Hyperparathyroidism and Fibromyalgia Mimicking Rheumatoid Arthritis

Middle East Pain Syndrome (MEPS) Vitamin D3 Deficiency Induced Hyperparathyroidism and Fibromyalgia Mimicking Rheumatoid Arthritis

Commentary on: Middle East Pain Syndrome is A Pollution-Induced New Disease Mimicking Rheumatoid Arthritis

Middle east pain syndrome is a pollution-induced new disease mimicking rheumatoid arthritis

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