Lymphatic obstruction in rheumatoid arthritis: a cause for upper limb oedema.
Peripheral lymphatic obstruction has been demonstrated by lymphangiography as a cause of upper limb oedema in 2 patients with seronegative rheumatoid disease.
Adult↗
Biomedical subjects
R T de Silva
Publications and source records attributed to R T de Silva.
Iatrogenic fluorosis.
A 69-year-old spinster presented with a history of generalised bone pains in September 1977. She was asthmatic and had been treated with 60 mg sodium fluoride and three Calcium Sandoz tablets daily for three years in an attempt to minimize steroid-induced osteoporosis. She was subsequently found to have fluorosis as shown by radiological osteosclerosis in vertebrae and pelvis with histological changes of osteomalacia on bone biopsy and a high bone fluoride content. A trial regimen for osteoporosis which is currently being assessed in various centres includes fluoride along with supplementary calcium and Vit D to prevent the production of osteomalacia which may occur with the fluoride salt alone. The case described here emphasises the potential toxicity of therapeutic dosages of fluoride when prescribed with calcium alone and emphasises the need for careful clinical and biochemical monitoring in all patients receiving therapeutic dosages of fluoride.
Aged↗