Ab1261 cadmium Toxicity as a Probable Cause of Osteopenia in Adolescents and Its Relation to Bad Dietary Habits

Elbeialy, Adel; Eldesouky, Hesham

doi:10.1136/annrheumdis-2019-eular.731

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%

“…Heavy metal pollution, such as cadmium and lead, is one of the most likely causes of vitamin D insu ciency in the Middle East. [7,8] The mitochondria of the kidney's proximal convoluted tubule cells produce circulating 1α,25dihydroxyvitamin D3 [1,25(OH)2D3], and parathyroid hormone (PTH) evidently increases 1,25(OH)2D3 production while 1,25(OH)2D3 suppresses PTH production. [9] Cadmium prefers to accumulate in the kidneys.…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Introductionmentioning

confidence: 99%

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

et al. 2021

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RETRACTED ARTICLE: 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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A Syndrome of Vitamin D3 Deficiency/Fibromyalgia/Hyperparathyroidism Mimicking Rheumatoid Arthritis, a Clinical Prospective Study

Elbeialy¹,

Bauomi²,

Elnaggar³

et al. 2021

OJRA

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Objectives: Rheumatoid arthritis is sometimes misdiagnosed for other diseases, like psoriatic arthritis, erosive OA, viral arthritis, reactive arthritis, IBD arthritis, Lyme's disease, and palindromic rheumatism. Secondary hyperparathyroidism was not included in the differential diagnosis of RA, though it sometimes presents with joint pains and tenderness, and even arthritis. Fibromyalgia is a psychosomatic disorder characterized by chronic widespread pain and tender areas. Mimicry of some manifestations of these diseases sometimes results in misdiagnosis as RA. Methods: Two hundred patients previously diagnosed as RA from outpatient clinics in Al-Azhar Faculty of Medicine, attended as not responding to medical treatment of RA. All patients were subjected to a re-evaluation of disease activity including HAQ, and DAS 28, CDAI, and SDAI. Also, we measured serum vitamin D3, PTH, total and ionized Calcium, Phosphorus, Uric acid, ACPA, and other routine lab. All patients were exposed to various radiological imaging modalities. Results: Cases not responding to RA treatment were reevaluated and were found to have a syndrome of fibromyalgia associated with vitamin D3 deficiency and secondary hyperparathyroidism. Conclusions: Fibromyalgia/Hyperparathyroidism syndrome is an underdiagnosed disease, which results from chronic vitamin D3 deficiency. SHPT can cause bone erosions, which are mostly shaggy in appearance and distributed in the radiocarpal, radioulnar, metacarpophalangeal and distal interphalangeal joints, in contrast to that which predominate proximal IP joints of rheumatoid arthritis. Radiology of FM/HPT syndrome patients revealed a sign of spur-like excrescences in terminal finger tufts unilaterally or bilaterally, which we think is pathognomonic.

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Ab1261 cadmium Toxicity as a Probable Cause of Osteopenia in Adolescents and Its Relation to Bad Dietary Habits

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

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

A Syndrome of Vitamin D3 Deficiency/Fibromyalgia/Hyperparathyroidism Mimicking Rheumatoid Arthritis, a Clinical Prospective Study

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