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Knitza J, Schett G, Manger B. Rheumatologische paraneoplastische Syndrome. AKTUEL RHEUMATOL 2020. [DOI: 10.1055/a-1201-2407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
ZusammenfassungRheumatologische paraneoplastische Syndrome sind selten, stellten jedoch eine
wichtige Differenzialdiagnose zu klassischen rheumatologischen Krankheitsbildern
dar. Durch das Erkennen der eindrücklichen Syndrome mit typischen Labor-
und Untersuchungsbefunden ist oftmals eine beschleunigte Diagnose der
zugrundeliegenden Malignität und kurative Therapie möglich. In
dieser Übersichtsarbeit werden die Charakteristika rheumatologischer
paraneoplastischer Syndrome vorgestellt.
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Affiliation(s)
- Johannes Knitza
- Medizinische Klinik 3 – Rheumatologie und Immunologie,
Universitätsklinikum Erlangen, Erlangen
| | - Georg Schett
- Medizinische Klinik 3 – Rheumatologie und Immunologie,
Universitätsklinikum Erlangen, Erlangen
| | - Bernhard Manger
- Medizinische Klinik 3 – Rheumatologie und Immunologie,
Universitätsklinikum Erlangen, Erlangen
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Liew ALF, Ting Y. Pachydermodactyly: A Case Report of a Little-Known and Benign Form of Digital Fibromatosis. AMERICAN JOURNAL OF CASE REPORTS 2020; 21:e923344. [PMID: 32424112 PMCID: PMC7262483 DOI: 10.12659/ajcr.923344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pachydermodactyly, a benign and self-limiting cause of cutaneous fibromatosis, is an under-recognized condition. This little-known condition is important, as it mimics inflammatory arthropathy. CASE REPORT A 16-year-old male presented with a 2-year history of progressive, asymptomatic soft tissue swelling of the proximal interphalangeal joints (PIPJs) affecting the second to fourth fingers bilaterally. He had participated in kayaking for the last 1-2 years. Physical examination revealed only painless, saccular, subcutaneous swelling around the PIPJs. Plain radiograph and MRI showed cutaneous thickening around the PIPJs, with no evidence of arthropathy. Blood investigations including inflammatory markers and autoimmune panel were normal. Skin biopsy showed thickened collagen in the dermis, acanthosis, and hyperkeratosis. The patient and family opted for observation and cessation of kayaking. Follow-up at 2 years showed stable disease. A diagnosis of pachydermodactyly was made. CONCLUSIONS Progressive, asymptomatic swelling of proximal interphalangeal joints, especially in young males, should prompt the consideration of pachydermodactyly as a potential differential diagnosis. Because of its benign course, correct recognition can help to prevent undue patient anxiety and avoid inappropriate investigation and treatment.
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Affiliation(s)
| | - Yonghan Ting
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore
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3
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Trandafir LM, Leon MM, Frasinariu O, Baciu G, Dodi G, Cojocaru E. Current Practices and Potential Nanotechnology Perspectives for Pain Related to Cystic Fibrosis. J Clin Med 2019; 8:jcm8071023. [PMID: 31336857 PMCID: PMC6678759 DOI: 10.3390/jcm8071023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/08/2019] [Accepted: 07/10/2019] [Indexed: 12/31/2022] Open
Abstract
Pain is a complex, multidimensional process that negatively affects physical and mental functioning, clinical outcomes, quality of life, and productivity for cystic fibrosis (CF) patients. CF is an inherited multi-system disease that requires a complete approach in order to evaluate, monitor and treat patients. The landscape in CF care has changed significantly, with currently more adult patients than children worldwide. Despite the great advances in supportive care and in our understanding regarding its pathophysiology, there are still numerous aspects of CF pain that are not fully explained. This review aims to provide a critical overview of CF pain research that focuses on pain assessment, prevalence, characteristics, clinical association and the impact of pain in children and adults, along with innovative nanotechnology perspectives for CF management. Specifically, the paper evaluates the pain symptoms associated with CF and examines the relationship between pain symptoms and disease severity. The particularities of gastrointestinal, abdominal, musculoskeletal, pulmonary and chest pain, as well as pain associated with medical procedures are investigated in patients with CF. Disease-related pain is common for patients with CF, suggesting that pain assessment should be a routine part of their clinical care. A summary of the use of nanotechnology in CF and CF-related pain is also given. Further research is clearly needed to better understand the sources of pain and how to improve patients’ quality of life.
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Affiliation(s)
- Laura M Trandafir
- Pediatric Department, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
| | - Magdalena M Leon
- Medical I Department, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
| | - Otilia Frasinariu
- Pediatric Department, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
| | - Ginel Baciu
- Pediatric Department, "Dunărea de Jos" University of Galati, 800008 Galati, Romania
| | - Gianina Dodi
- Advanced Centre for Research-Development in Experimental Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania.
| | - Elena Cojocaru
- Morpho-Functional Sciences Department, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
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5
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Rheumatic paraneoplastic syndromes – A clinical link between malignancy and autoimmunity. Clin Immunol 2018; 186:67-70. [DOI: 10.1016/j.clim.2017.07.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/31/2022]
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Abstract
Hypertrophic osteoarthropathy (HOA) is a rare paraneoplastic syndrome characterized by digital clubbing, periosteal reaction, polyarthralgia, arthritis, and synovitis. Herein, we report a case series of patients with secondary HOA caused by non-pleural or pulmonary tumors.The radiologic databases of 2 tertiary university hospitals were retrospectively screened for secondary HOA patients. In addition, a systemic review of the published case reports. Only HOA cases with non-pleural or pulmonary malignancies were involved into the study. HOA in primary pleural or pulmonary malignant or benign disorders, as well in inflammatory diseases were excluded. In all cases, plain radiography was performed and clinical signs were documented.In our databases, 6 patients with secondary HOA were identified. In addition, the systemic review yielded 24 eligible patients. The most prevalent primary tumors were nasopharyngeal carcinoma and esophageal cancer in 6 patients (20%), respectively. In 17 patients, (56.7%) HOA was associated with lung metastases, and in 10 patients (33.3%), no lung metastases were detected. In 14 patients (46.7%), HOA was symptomatically before a tumor diagnosis was made. Plain radiography displayed typically features with periostal enlargement in every case.This study is the first report about secondary HOA caused by non-pleural or pulmonary tumors. Various primary tumors were identified, including several rare tumors such as sarcomas. HOA is a rare disorder with typically radiologically findings, which is not only associated with lung cancer or pleural mesothelioma and can even occur in tumor patients without lung metastasis.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig
| | - Leonard Leifels
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig
| | - Andreas Gunter Bach
- Department of Diagnostic Radiology, Martin-Luther University Halle (Saale), Halle (Saale), Germany
| | - Alexey Surov
- Department of Diagnostic and Interventional Radiology, University Hospital Leipzig, Leipzig
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7
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Binder M, Saad M. Hypertrophic osteoarthropathy in a young adult male from Berber, Sudan (2nd-3rd century CE). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2017; 18:52-62. [PMID: 28888393 DOI: 10.1016/j.ijpp.2017.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 05/02/2017] [Accepted: 05/15/2017] [Indexed: 06/07/2023]
Abstract
Hypertrophic osteoarthropathy (HOA) is a pathological condition characterised by extensive periosteal new bone formation (NBF) on the diaphyses of the long bones, metacarpal and metatarsal bones. In modern clinical contexts, the secondary form of the disease is common and most often occurs secondary to intra-thoracic cancer and other forms of chronic pulmonary disease. Paleopathological evidence for HOA on the other hand has only occasionally been reported. Here we report a young adult male from the Meriotic cemetery at Berber in Sudan (2nd-3rd century CE) displaying widespread NBF on the diaphyses of the upper and lower limb bones, metacarpal and metatarsal bones, as well as the pelvis and scapulae. While several pathological conditions have to be considered as differential diagnostic options for NBF in the post-cranial skeleton, HOA is the most likely diagnosis, based on the distribution of the changes observed in this individual, as well as their macroscopic and radiographic characteristics. A chronic pulmonary condition as indicated by NBF on the visceral side of the ribs may represent the underlying cause for the HOA. This individual represents the first paleopathological case of HOA reported from an archaeological site in Africa.
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Affiliation(s)
- M Binder
- Austrian Archaeological Institute, Austrian Academy of Sciences, Franz Klein-Gasse 1, 1190 Vienna, Austria.
| | - M Saad
- National Corporation for Antiquities and Museums of Sudan, PO Box 178, Khartoum, Sudan
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Abstract
Synovitis is the characteristic feature of inflammatory joint disease. If synovitis is localized to interphalangeal joints, rheumatoid arthritis, psoriatic arthritis, and juvenile idiopathic arthritis are among the most common differential diagnoses. The absence of pain, tenderness, and limitation of function despite progressive swelling of proximal interphalangeal joints suggests an alternative diagnosis, for example pachydermodactyly (PDD). This is a benign disease, associated with asymptomatic, progressive swelling of periarticular soft tissue, which usually occurs in young males. PDD is probably the result of repetitive mechanical stimulation. One hundred and twenty-one cases have been reported in the literature. Some of these were initially misdiagnosed and treated for inflammatory arthritis. We provide a comprehensive review of the literature on pachydermodactyly to promote awareness of this rare but important differential diagnosis of arthritis.
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Affiliation(s)
- Tomáš Dallos
- Second Department of Pediatrics, Comenius University Medical School, Limbová 1, 83340, Bratislava, Slovakia,
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Hübscher O. Pattern recognition in arthritis. Rheumatology (Oxford) 2015. [DOI: 10.1016/b978-0-323-09138-1.00029-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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10
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Baranowski A, Hansen M. [Bronchial carcinoma and knee pain. Secondary hypertrophic osteoarthropathy]. Unfallchirurg 2012; 116:744-8. [PMID: 23052705 DOI: 10.1007/s00113-012-2263-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Secondary hypertrophic osteoarthropathy (HOA), also known as Marie-Bamberger syndrome, is a rare neoplastic syndrome featuring clubbing of the tips of the digits, periosteal proliferation and synovial effusion of adjacent joints. We report a case where a patient without any other known medical condition developed persistent arthralgia and mobility restriction after bruising the left knee. As the initial X-ray examination of the knee showed a distinct periosteal proliferation of the left femoral bone, extended diagnostics were initiated during which a bronchial carcinoma was identified. After surgical removal of the primary tumor the symptoms of irritation in the knee joint recovered totally.
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Affiliation(s)
- A Baranowski
- Hochtaunus-Kliniken, Urseler Straße 33, Bad Homburg v.d.H, Germany.
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