Compensatory hyperparathyroidism following high fluoride ingestion - a clinico - biochemical correlation.

Abstract

OBJECTIVE: To evaluate the effect of varying ingestion of drinking water containing high fluorides and its effect on serum parathyroid hormone. DESIGN: Cross sectional clinical study. SETTING: S.M.S. Medical College, Jaipur. SUBJECT: 200 children were selected from four areas (50 from each area) consuming water containing 2.4, 4.6, 5.6 and 13.5 mg/l of fluoride. All children were in an age group of 6 to 12 years. METHODS: All children were graded for clinical, radiological and dental fluorosis and biochemical estimations were made for serum calcium, serum and urinary fluoride and serum parathyroid hormone. RESULTS: Serum calcium levels were well within normal range in the patients of all areas but an increase in serum parathyroid levels (S. PTH) was noted. The increased S. PTH was well correlated with increase in fluoride ingestion. The severity of clinical and skeletal fluorosis was observed to increase with increase in S. PTH concentration. CONCLUSIONS: High Fluoride ingestion has a definite relationship with increased parathyroid hormone secretion, which may be responsible for maintaining serum calcium levels and may have a role in toxic manifestations of fluorosis.