Clubbing pathophysiology: Difference between revisions

Jump to navigation Jump to search
(Created page with "__NOTOC__ {{Clubbing}} {{CMG}} ==Overview== ==Pathophysiology== The exact cause for sporadic clubbing is unknown, and there are numerous theories as to its cause. [[Vasodilat...")
 
Line 3: Line 3:
{{CMG}}
{{CMG}}
==Overview==
==Overview==
==Pathophysiology==
The cause for sporadic clubbing is not known, and there are numerous theories as to its cause. [[Vasodilation]] (distended blood vessels), secretion of [[growth factor]]s (such as [[platelet-derived growth factor]] and [[hepatocyte growth factor]]) from the lungs, and other mechanisms have been proposed. The discovery of disorders in the [[prostaglandin]] metabolism in primary osteo-arthropathy has led to suggestions that overproduction of [[PGE2]] by other tissues may be the causative factor for clubbing.<ref>Uppal S, Diggle CP, Carr IM, et al (June 2008). "Mutations in 15-hydroxyprostaglandin dehydrogenase cause primary hypertrophic osteoarthropathy". Nat. Genet. 40 (6): 789–93. doi:10.1038/ng.153. PMID 18500342</ref>
 
The exact cause for sporadic clubbing is unknown, and there are numerous theories as to its cause. [[Vasodilation]] (distended blood vessels), secretion of [[growth factor]]s (such as [[platelet-derived growth factor]] and [[hepatocyte growth factor]]) from the lungs, and other mechanisms have been proposed. The discovery of disorders in the [[prostaglandin]] metabolism in primary osteo-arthropathy has led to suggestions that overproduction of [[PGE2]] by other tissues may be the causative factor for clubbing.<ref>Uppal S, Diggle CP, Carr IM, et al (June 2008). "Mutations in 15-hydroxyprostaglandin dehydrogenase cause primary hypertrophic osteoarthropathy". Nat. Genet. 40 (6): 789–93. doi:10.1038/ng.153. PMID 18500342</ref>


===Associated Conditions===
===Associated Conditions===
Line 41: Line 39:
*Secondary HOA
*Secondary HOA
**It is usually associated with [[lung cancer]], pulmonary infections, [[cystic fibrosis]], [[right-to-left cardiac shunts]], and less often in [[Hodgkin's lymphoma]] and [[cirrhosis]]. Among patients with lung cancer, HOA is most frequently associated with [[adenocarcinoma]] and least frequently with [[small cell carcinoma]] <ref name="pmid9872183">{{cite journal |author=Sridhar KS, Lobo CF, Altman RD |title=Digital clubbing and lung cancer |journal=Chest |volume=114 |issue=6 |pages=1535–7 |year=1998 |month=December |pmid=9872183 |doi= |url=}}</ref> Rarely, [[arterial vascular prosthesis infections]] may be associated with HOA<ref name="pmid16721260">{{cite journal |author=Alonso-Bartolomé P, Martínez-Taboada VM, Pina T, Blanco R, Rodriguez-Valverde V |title=Hypertrophic osteoarthropathy secondary to vascular prosthesis infection: report of 3 cases and review of the literature |journal=Medicine (Baltimore) |volume=85 |issue=3 |pages=183–91 |year=2006 |month=May |pmid=16721260 |doi=10.1097/01.md.0000224714.27508.8b |url=}}</ref>. Clinical features suggestive of vascular infection-related HOA include clubbing or periosteal new bone formation in a single limb.
**It is usually associated with [[lung cancer]], pulmonary infections, [[cystic fibrosis]], [[right-to-left cardiac shunts]], and less often in [[Hodgkin's lymphoma]] and [[cirrhosis]]. Among patients with lung cancer, HOA is most frequently associated with [[adenocarcinoma]] and least frequently with [[small cell carcinoma]] <ref name="pmid9872183">{{cite journal |author=Sridhar KS, Lobo CF, Altman RD |title=Digital clubbing and lung cancer |journal=Chest |volume=114 |issue=6 |pages=1535–7 |year=1998 |month=December |pmid=9872183 |doi= |url=}}</ref> Rarely, [[arterial vascular prosthesis infections]] may be associated with HOA<ref name="pmid16721260">{{cite journal |author=Alonso-Bartolomé P, Martínez-Taboada VM, Pina T, Blanco R, Rodriguez-Valverde V |title=Hypertrophic osteoarthropathy secondary to vascular prosthesis infection: report of 3 cases and review of the literature |journal=Medicine (Baltimore) |volume=85 |issue=3 |pages=183–91 |year=2006 |month=May |pmid=16721260 |doi=10.1097/01.md.0000224714.27508.8b |url=}}</ref>. Clinical features suggestive of vascular infection-related HOA include clubbing or periosteal new bone formation in a single limb.
==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{WH}}
{{WH}}
{{WS}}
{{WS}}

Revision as of 00:16, 19 August 2015

Clubbing Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Clubbing from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

Echocardiography or Ultrasound

Other Diagnostic Studies

Treatment

Medical Therapy

Case Studies

Case #1

Clubbing pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Clubbing pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Clubbing pathophysiology

CDC on Clubbing pathophysiology

Clubbing pathophysiology in the news

Blogs on Clubbing pathophysiology

Directions to Hospitals Treating Clubbing

Risk calculators and risk factors for Clubbing pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

The cause for sporadic clubbing is not known, and there are numerous theories as to its cause. Vasodilation (distended blood vessels), secretion of growth factors (such as platelet-derived growth factor and hepatocyte growth factor) from the lungs, and other mechanisms have been proposed. The discovery of disorders in the prostaglandin metabolism in primary osteo-arthropathy has led to suggestions that overproduction of PGE2 by other tissues may be the causative factor for clubbing.[1]

Associated Conditions

Although many diseases are associated with clubbing such as oxygen deprivation and lung, heart, or liver disease, the reports are fairly anecdotal. Prospective studies of patients presenting with clubbing have not yet been performed, and hence there is no conclusive evidence of these associations.

References

  1. Uppal S, Diggle CP, Carr IM, et al (June 2008). "Mutations in 15-hydroxyprostaglandin dehydrogenase cause primary hypertrophic osteoarthropathy". Nat. Genet. 40 (6): 789–93. doi:10.1038/ng.153. PMID 18500342
  2. Sridhar KS, Lobo CF, Altman RD. Digital clubbing and lung cancer. Chest 1998;114:1535-37. PMID 9872183
  3. Epstein O, Dick R, Sherlock S (1981). "Prospective study of periostitis and finger clubbing in primary biliary cirrhosis and other forms of chronic liver disease". Gut. 22 (3): 203–6. PMID 7227854.
  4. Naeije R. Hepatopulmonary syndrome and portopulmonary hypertension. Swiss Med Wkly. 2003;133:163-9. PMID 12715285.
  5. Template:GPnotebook
  6. Uppal S, Diggle CP, Carr IM; et al. (2008). "Mutations in 15-hydroxyprostaglandin dehydrogenase cause primary hypertrophic osteoarthropathy". Nat. Genet. 40 (6): 789–93. doi:10.1038/ng.153. PMID 18500342. Unknown parameter |month= ignored (help)
  7. Sridhar KS, Lobo CF, Altman RD (1998). "Digital clubbing and lung cancer". Chest. 114 (6): 1535–7. PMID 9872183. Unknown parameter |month= ignored (help)
  8. Alonso-Bartolomé P, Martínez-Taboada VM, Pina T, Blanco R, Rodriguez-Valverde V (2006). "Hypertrophic osteoarthropathy secondary to vascular prosthesis infection: report of 3 cases and review of the literature". Medicine (Baltimore). 85 (3): 183–91. doi:10.1097/01.md.0000224714.27508.8b. PMID 16721260. Unknown parameter |month= ignored (help)

Template:WH Template:WS