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Palui R, Sridharan K, Sahoo J, Suryadevara V, Kamalanathan S, Naik D, Halanaik D, Durgia H, Raj H. Role of bisphosphonates in hypertrophic osteoarthropathy: a systematic review. Endocrine 2024:10.1007/s12020-024-03804-5. [PMID: 38564085 DOI: 10.1007/s12020-024-03804-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The role of bisphosphonates (BP) in hypertrophic osteoarthropathy (HPOA) is unclear. We presented a case of primary HPOA and performed a systematic review of literature on the effect of BP on treatment response in primary and secondary HPOA. METHODS The study was prospectively registered in PROSPERO (CRD42022343786). We performed a PubMed literature search that restricted to the English language. We included patients diagnosed with primary or secondary HPOA who received BP. The primary endpoint assessed was the effectiveness of BP on response to pain or arthritis. Secondary outcomes included timing, degree, and duration of response, comparison to other HPOA therapies, impact of BP on radiology, bone scan, bone turnover markers, and adverse effects of BP. RESULTS Literature search retrieved only case reports. Forty-five patients (21 primary, 24 secondary HPOA) had received BP. Majority(88.3%) experienced improvement in pain or arthritis. Response was gradual for primary HPOA and within a median of 3 to 7 days for secondary HPOA after treatment with BP. Most patients had reduced bone scan uptake after BP. When other HPOA therapies were tried, half responded to BP after not having previously responded to other therapies, while a third received the treatments concurrently, making it difficult to attribute treatment response to a drug. Reporting of other secondary outcomes was very heterogenous and qualitative to draw conclusions. No major adverse effects have been reported for BP in HPOA. CONCLUSION Bisphosphonates provide an effective and safe treatment option for primary and secondary HPOA. However, there is a lack of randomized controlled trials.
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Affiliation(s)
- Rajan Palui
- Consultant Endocrinologist, The Mission Hospital, Durgapur, West Bengal, India
| | - Kalyani Sridharan
- Department of Endocrinology, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Varun Suryadevara
- Associate Consultant Endocrinologist, Apollo Hospitals, Bangalore, Karnataka, India
| | - Sadishkumar Kamalanathan
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Dukhabandhu Naik
- Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Dhanapathi Halanaik
- Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Harsh Durgia
- Consultant Endocrinologist, Dr Harsh's Endocrine and Diabetes Center, Rajkot, Gujarat, India
| | - Henith Raj
- Consultant Endocrinologist, Dr Jayaharan Memorial Hospital, Nagercoil, Tamilnadu, India
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Koliakos E, Chappalley D, Kalogiannis E, Sgardello S, Christodoulou M. Pierre-Marie Bamberger Syndrome Leading to the Diagnosis and Surgical Treatment of a Localized Lung Cancer. Cureus 2023; 15:e48991. [PMID: 38111395 PMCID: PMC10726300 DOI: 10.7759/cureus.48991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2023] [Indexed: 12/20/2023] Open
Abstract
Hypertrophic osteoarthropathy (HOA), manifested with digital clubbing, tubular bone periostosis, and large joint synovial effusions, exists in two forms: primary, which is the rarest form, and secondary. The latter is frequently associated with lung diseases and, in some cases, with non-small cell lung cancer (NSCLC) and is thus expressed in the form of a paraneoplastic syndrome. We report the case of a male smoker who was presented with secondary hypertrophic osteoarthropathy and was subsequently diagnosed with primary adenocarcinoma of the lung. A 63-year-old male with a history of ischemic heart disease and heavy tobacco consumption (60 pack-years) presented with painful osteoarthritis of all four extremities. A chest computed tomography (CT), a positron emission tomography (PET) scan, and a bronchoscopy revealed a 9 cm mass within the right lower lobe without mediastinal adenopathy. Bilateral lower limb X-rays revealed osteoarthropathy of the tibia. A right lower lobectomy and mediastinal lymph node dissection were performed. Final histopathology analysis reported an advanced mixed pulmonary adenocarcinoma. The postoperative course was uneventful and the patient was discharged on postoperative day 6. This report has highlighted the importance of clinical awareness of the association between HOA and carcinoma of the lung.
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Affiliation(s)
| | - Dimitri Chappalley
- Department of Visceral Surgery, CHUV (Centre Hospitalier Universitaire Vaudois) - Lausanne University Hospital, Lausanne, CHE
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Paraneoplastic musculoskeletal disorders: review and update for radiologists. Skeletal Radiol 2023; 52:421-433. [PMID: 35604445 DOI: 10.1007/s00256-022-04074-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/02/2023]
Abstract
Rheumatic paraneoplastic syndromes are rare syndromes that occur at distant sites from the underlying tumor and may involve the bones, joints, fasciae, muscles, or vessels. In the absence of a known tumor, early recognition of a rheumatic syndrome as paraneoplastic permits dedicated work-up for, and potentially early treatment of an occult malignancy. Although there is a continuously growing list of paraneoplastic rheumatic disorders, not all of these disorders have a well-established association with a neoplastic process. The goals of this article are to review the clinical characteristics, diagnostic work-up, and imaging findings of well-documented rheumatic paraneoplastic disorders.
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Einwaller J, Esmieu S, Sanchez FV. Paraneoplastic hypertrophic osteopathy in a Great Dane with rib sarcoma. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Joy Einwaller
- Diagnostic Imaging Service Dick White Referrals Six Mile Bottom UK
- Internal Medicine Service Dick White Referrals Six Mile Bottom UK
| | - Shanti Esmieu
- Diagnostic Imaging Service Dick White Referrals Six Mile Bottom UK
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Parperis K, Constantinidou A, Panos G. Paraneoplastic Arthritides: Insights to Pathogenesis, Diagnostic Approach, and Treatment. J Clin Rheumatol 2021; 27:e505-e509. [PMID: 31743270 DOI: 10.1097/rhu.0000000000001202] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Paraneoplastic arthritides are a group of inflammatory rheumatic syndromes induced by an occult and manifest malignancy, characterized by a wide range of musculoskeletal signs and symptoms that masquerade other rheumatic diseases such as rheumatoid arthritis. Although the pathogenesis of paraneoplastic arthritides is unknown, immune-mediated mechanisms can induce a paraneoplastic syndrome, with a dominant feature the polyarthritis. Common entities of paraneoplastic arthritides include paraneoplastic polyarthritis, hypertrophic osteoarthropathy, remitting seronegative symmetrical synovitis with pitting edema, palmar fasciitis and polyarthritis, and polyarthritis and panniculitis associated with pancreatic carcinoma. The electronic databases PubMed and Scopus were scrutinized using the following terms: paraneoplastic arthritis, paraneoplastic polyarthritis, or paraneoplastic rheumatic diseases. Abstracts, full articles, and selected references were reviewed. The aim of the present narrative review article was to describe the clinical characteristics, diagnostic evaluation, and management of paraneoplastic arthritides, and highlight the challenges that health care providers may encounter, distinguishing those conditions from other autoimmune rheumatic disorders. Future studies are needed to give insight into the mechanisms associated with paraneoplastic arthritides, leading to the development of novel diagnostic biomarkers.
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Affiliation(s)
- Konstantinos Parperis
- From the Division of Rheumatology, Department of Internal Medicine, University of Arizona College of Medicine/Maricopa Integrated Health System, Phoenix, AZ; and University of Cyprus Medical School
| | | | - George Panos
- Department of Internal Medicine, University of Cyprus Medical School, Nicosia, Cyprus
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Oh KS, Lee SY, Min SH, Ryu C, Shin HY. Hypertrophic osteoarthropathy in renal cell carcinoma - A case report. Anesth Pain Med (Seoul) 2021; 16:290-294. [PMID: 34233412 PMCID: PMC8342818 DOI: 10.17085/apm.20092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/16/2021] [Indexed: 11/22/2022] Open
Abstract
Background Hypertrophic osteoarthropathy (HOA) is a rare clinical condition including an abnormal periosteal reaction in the long bones that causes painful swelling and tenderness of the extremities, digital clubbing, arthritis, synovitis, and joint effusions. Most cases are associated with tumorous conditions and most commonly with lung cancer. HOA has been rarely reported in association with other cancers. Case A patient with a history of recurrent renal cell carcinoma was referred to our clinic with bilateral leg pain, knee joint effusion, and arthritis. Simple radiography and bone scintigraphy confirmed a diagnosis of HOA. Oral non-steroidal anti-inflammatory drugs, joint fluid aspiration, and intra-articular injection of pain medications were found to be effective in the management of HOA pain. Conclusions HOA prognosis depends on the underlying disease, therefore, cancer treatment is critical. This case demonstrates the need to consider HOA in patients with various malignancies who present with bone or joint pain of the extremities.
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Affiliation(s)
- Kyung Seo Oh
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Seung Young Lee
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Se-Hee Min
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Choongun Ryu
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Hwa-Yong Shin
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Seoul, Korea
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Poddar K, Pathikonda L, Villamil M. Sudden onset polyarthritis as a paraneoplastic syndrome from non-small cell lung cancer. J Community Hosp Intern Med Perspect 2020; 10:174-178. [PMID: 32850061 PMCID: PMC7425616 DOI: 10.1080/20009666.2020.1749503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
A 48-year-old male presented to the emergency room for 2 weeks of joint pain and swelling of his four extremities. His symptoms started suddenly and were quite debilitating. His hands, fingers, knees, and ankles were so swollen and painful that he was unable to get out of bed and had to use crutches to ambulate. He also complained of anorexia, nausea, and lack of energy over the past few months, but denied any other complaints. His only medical history was a traumatic left tibia fracture 1 year ago. The patient had a 30-pack year history of smoking tobacco and used marijuana daily. The patient recently had an arthrocentesis at an outside hospital which was non-diagnostic and showed no infection. Given his symptoms, a thorough rheumatic workup was ordered. The ESR and CRP were elevated. ANA, rheumatoid factor, HLA B27, HIV, hepatitis panel, TSH, T4, Coombs antibodies, gonorrhea, chlamydia, CCP, alpha 1 antitrypsin, parvovirus, fungal antibodies, and myeloperoxidase antibodies were all within the normal range. X-rays of the hands, knees, and ankles were ordered. The images showed diffuse joint swelling with no fractures, dislocations, or hardware mispositioning. It also showed tissue swelling in the fingers that could not exclude hypertrophic pulmonary osteoarthropathy. A chest x-ray revealed a large 8.5 cm oval mass in the right upper lobe. A follow-up CT revealed a massive right upper lobe lung mass concerning for malignancy versus fungal etiology. A CT guided biopsy of the mass was performed and revealed a poorly differentiated non-small-cell lung cancer, favoring adenocarcinoma. Further CT imaging revealed limited stage disease. During the hospitalization, the patient was provided with NSAIDs for his joint pain, which provided minimal benefit. There was little to no improvement in his joint swelling. Oncology was consulted and further evaluation in the outpatient setting was recommended to determine if he would be a surgical candidate and/or to decide the best chemotherapeutic regimen. This case demonstrates an unusual presentation of non-small-cell lung cancer and highlights the importance of maintaining malignancy on the differential diagnosis for sudden arthritis.
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Johns AC, Sorenson C, Rogers A, Agne JL, D'Souza DM, Das JK, Issa M, Perna G, Williams TM, Meara A, Kitchin T, Haglund KE, Owen DH. Clinical Course of Hypertrophic Pulmonary Osteoarthropathy in a Patient Receiving Immune Checkpoint Inhibitor Therapy. Clin Lung Cancer 2020; 21:e243-e245. [PMID: 32067849 DOI: 10.1016/j.cllc.2020.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 12/20/2019] [Accepted: 01/20/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Andrew C Johns
- Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH.
| | - Chad Sorenson
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Alan Rogers
- Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Julia L Agne
- Division of Palliative Medicine, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Desmond M D'Souza
- Division of Thoracic Surgery, Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Jishu K Das
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Majd Issa
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Gina Perna
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Terence M Williams
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Alexa Meara
- Division of Rheumatology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Trevor Kitchin
- Division of Sports Medicine, Department of Family Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Karl E Haglund
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - Dwight H Owen
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH
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Rheumatologic Manifestations of CF. Respir Med 2020. [DOI: 10.1007/978-3-030-42382-7_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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10
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Gai X, Yang W, Zhu H, Sun Y. Digital clubbing occurring in intrathoracic Hodgkin lymphoma: A case report. Medicine (Baltimore) 2019; 98:e18388. [PMID: 31861002 PMCID: PMC6940046 DOI: 10.1097/md.0000000000018388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE Digital clubbing is rarely associated with lymphoma. This study reports a case of intrathoracic Hodgkin lymphoma with digital clubbing and reviews the current literature regarding the clinical characteristics of this condition. PATIENT CONCERN A 21-year-old woman presented with a 3-month history of cough and 1 month of fever, with apparent digital clubbing. A computed tomography (CT) scan of the lungs revealed a large pulmonary mass. DIAGNOSIS A CT-guided transthoracic needle biopsy was conducted. Pathology determined a diagnosis of Hodgkin lymphoma. INTERVENTIONS The patient underwent 6 courses of chemotherapy and intensification, followed by autografting. OUTCOMES The patient recovered and a complete hematological remission was obtained. The patient is alive with no evidence of disease 60 months after diagnosis, with the digital clubbing of the fingers and toes completely resolved. CONCLUSION Patients with digital clubbing and intrathoracic lesions need to be examined carefully to determine tumor malignancy.
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11
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Primary Hypertrophic Osteoarthropathy With SLCO2A1 Mutation in a Chinese Patient Successfully Treated With Etoricoxib. J Clin Rheumatol 2019; 24:164-167. [PMID: 29239930 DOI: 10.1097/rhu.0000000000000647] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Anwar A, Jafri F, Ashraf S, Jafri MAS, Fanucchi M. Paraneoplastic syndromes in lung cancer and their management. ANNALS OF TRANSLATIONAL MEDICINE 2019; 7:359. [PMID: 31516905 DOI: 10.21037/atm.2019.04.86] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Paraneoplastic syndromes are most frequently associated with lung cancer. This review considers a variety of paraneoplastic syndromes associated with lung cancer and discusses their pathophysiology, clinical features and management options.
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Affiliation(s)
- Asad Anwar
- Department of Internal Medicine, Westchester Medical Center, Valhalla, NY, USA
| | - Firas Jafri
- Department of Internal Medicine, Westchester Medical Center, Valhalla, NY, USA
| | - Sara Ashraf
- Department of Hematology/Oncology, Marshall University, Huntington, WV, USA
| | - Mohammad Ali S Jafri
- Department of Hematology/Oncology, Westchester Medical Center, Valhalla, NY, USA
| | - Michael Fanucchi
- Department of Hematology/Oncology, Westchester Medical Center, Valhalla, NY, USA
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Ribigan AC, Bajenaru OL, Antochi FA, Bajenaru OA. Nociceptive pain unmasking a serious pathology - paraneoplastic hypertrophic osteoarthropathy: A case report. Medicine (Baltimore) 2019; 98:e15900. [PMID: 31169701 PMCID: PMC6571421 DOI: 10.1097/md.0000000000015900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Hypertrophic osteoarthropathy, also named Pierre Marie-Bamberger syndrome, represents a rare medical condition that may be considered either a primary or a secondary disease, and lung malignancies are responsible for more than two-thirds of the cases with secondary forms of the disease. PATIENT CONCERNS We present the case of a 41-year-old man referred to our Neurology Department for pain that was considered secondary to cervical disc protrusions. The neurologic examination was normal. However, the general examination showed digital clubbing, right lateral cervical adenopathy, and pachydermia. The radiographic examinations of the upper and lower limbs depicted osseous abnormalities typical for periostosis, and the computed tomography of the thorax showed the presence of a mass lesion in the right upper pulmonary lobe. High values of vascular endothelial growth factor were also found. The patient was admitted to the Pneumology Clinic, where biopsy was performed from the lateral cervical adenopathy. DIAGNOSES The anatomopathological examination revealed multiple neoplastic infiltrates suggestive of adenocarcinoma metastasis. Based on the clinical examination and radiological and histologic findings, the diagnosis of pulmonary adenocarcinoma with lymph nodes metastases and paraneoplastic hypertrophic osteoarthropathy was established. INTERVENTIONS The patient received treatment with nonsteroidal antiinflammatory drugs and opiate analgesics that relieved the pain. OUTCOMES The patient was referred to the Oncology Department for further treatment of the primary pathology. He received different types of chemotherapeutics, immunotherapy, and radiotherapy. However, despite all therapeutic measures, the disease rapidly progressed and the patient died 9 months later. LESSONS This is an interesting case of a patient with an overlooked pathology, which was refereed to our clinic for further investigations of a pain that was considered neuropathic, secondary to small cervical protrusions. Conversely, the pain proved to be nociceptive and Pierre Marie-Bamberger syndrome was the positive diagnosis in our patient, as it can be associated with numerous diseases, especially of neoplastic origin.
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Affiliation(s)
- Athena Cristina Ribigan
- University Emergency Hospital Bucharest, Neurology Department
- Ana Aslan National Institute of Geriatry and Geriatrics, Geriatry and Geriatrics Department
| | - Ovidiu Lucian Bajenaru
- Ana Aslan National Institute of Geriatry and Geriatrics, Geriatry and Geriatrics Department
- University of Medicine and Pharmacy Carol Davila Bucharest, Department of Clinical Neurosciences, Bucharest, Romania
| | | | - Ovidiu Alexandru Bajenaru
- University Emergency Hospital Bucharest, Neurology Department
- Ana Aslan National Institute of Geriatry and Geriatrics, Geriatry and Geriatrics Department
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Elmore S, Wisse A, Chapin RW, Whelan TP, Silver RM. Voriconazole-associated periostitis presenting as hypertrophic osteoarthropathy following lung transplantation report of two cases and review of the literature. Semin Arthritis Rheum 2019; 49:319-323. [PMID: 31103239 DOI: 10.1016/j.semarthrit.2019.04.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/17/2019] [Accepted: 04/22/2019] [Indexed: 01/30/2023]
Abstract
BACKGROUND Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by abnormal proliferation of skin and osseous tissue frequently associated with underlying pulmonary disorders. Cardinal features include digital clubbing, periostitis and significant joint and bone pain. A number of recent reports have emerged of HOA and periostitis occurring in association with the antifungal agent voriconazole. METHODS We present two additional cases of voriconazole-induced HOA and periostitis in lung transplant recipients with a review the medical literature. RESULTS In both cases, symptoms were painful and severe enough to require opioid medication. Rapid improvement occurred within days of voriconazole cessation. A review of existing literature revealed an additional 17 cases of voriconazole-induced HOA and periostitis in lung transplant patients. CONCLUSION We highlight the importance of recognizing the association of voriconazole with painful HOA and periostitis in lung transplant patients receiving antifungal therapy. Management of this painful condition involves cessation of voriconazole therapy, which may necessitate alternative anti-fungal drug therapies as well as adjustment of immunosuppressive drug dosage since voriconazole is a strong drug-inducer.
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Affiliation(s)
- Stephen Elmore
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 822, Charleston, SC 29401, USA
| | - Amy Wisse
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC 29401, USA
| | - Russell W Chapin
- Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC 29401, USA
| | - Timothy P Whelan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Medical University of South Carolina, Charleston, SC 29401, USA
| | - Richard M Silver
- Division of Rheumatology and Immunology, Department of Medicine, Medical University of South Carolina, 96 Jonathan Lucas Street, Suite 822, Charleston, SC 29401, USA.
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Bozzao F, Bernardi S, Dore F, Zandonà L, Fischetti F. Hypertrophic osteoarthropathy mimicking a reactive arthritis: a case report and review of the literature. BMC Musculoskelet Disord 2018; 19:145. [PMID: 29759083 PMCID: PMC5952696 DOI: 10.1186/s12891-018-2068-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 04/30/2018] [Indexed: 01/05/2023] Open
Abstract
Background Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by abnormal proliferation of skin and periosteal tissues of the extremities. It can be a rare hereditary disease (pachydermoperiostosis) or can be secondary to various diseases, though mostly lung malignancies. Here, we report an unusual clinical presentation of HOA. Case presentation A 77-year-old man presented with fever, diarrhea, and an oligoarthritis involving the left knee and the ankles. Since left knee synovial fluid aspiration revealed an aseptic synovitis and Clostridium Difficile toxin was detectable in stool samples, a reactive arthritis secondary to a Clostridium Difficile induced colitis was initially suspected. However, the presence of a worsened digital clubbing and the lack of a good clinical response to steroid therapy led us to perform a radionuclide bone scanning, which revealed HOA. This turned out to be associated with a lepidic predominant lung adenocarcinoma, which was clinically and radiologically difficult to distinguish from a relapse of pneumonia. Conclusion Consistent with the literature, HOA tends to have a variable clinical presentation, mimicking that of various rheumatic diseases. This clinical case shows that HOA can present as a presumptive acute reactive arthritis, and it highlights the importance of patient’s follow-up in the differential diagnosis of inflammatory arthritis, especially when a worsened digital clubbing is present.
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Affiliation(s)
- Francesco Bozzao
- Department of Medical Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 449, 34149, Trieste, Italy.
| | - Stella Bernardi
- Department of Medical Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 449, 34149, Trieste, Italy
| | - Franca Dore
- ASUITS, Cattinara Teaching Hospital, Strada di Fiume 449, 34149, Trieste, Italy
| | - Lorenzo Zandonà
- ASUITS, Cattinara Teaching Hospital, Strada di Fiume 449, 34149, Trieste, Italy
| | - Fabio Fischetti
- Department of Medical Sciences, University of Trieste, Cattinara Teaching Hospital, Strada di Fiume 449, 34149, Trieste, Italy
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Flohr S, Jasch I, Langer A, Riesenberg M, Hahn J, Wisotzki A, Kierdorf H, Kierdorf U, Wahl J. Secondary hypertrophic osteoarthropathy in a male from the Early Medieval settlement of Lauchheim, Germany. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2018; 20:72-79. [PMID: 29496219 DOI: 10.1016/j.ijpp.2017.10.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 10/23/2017] [Accepted: 10/27/2017] [Indexed: 06/08/2023]
Abstract
Hypertrophic osteoarthropathy (HOA) is rarely diagnosed in archaeological human skeletons. Here, we report on the well-preserved skeleton of a middle-adult man from the early Medieval settlement site of Lauchheim (Germany) that exhibits pronounced multi-layered shell-like periosteal new bone formation in a bilaterally symmetric fashion on the long bones, the skeletal elements of the pelvis and those of the pectoral girdle. In addition, the two distal phalanges recovered show signs of osteoclastic resorption on their distal tuberosities. The distribution and morphology of the observed lesions are consistent with a diagnosis of HOA. The adult age at death of the individual and the co-occurrence of "healed" and "active" lesions suggest a secondary form of HOA. Given that only skeletal remains were available for study, the underlying (pulmonary or non-pulmonary) primary disease cannot be definitively ascertained in the present case. No osseous changes were found on the ribs, but signs of osteoclastic resorption were observed on the dorsal surface of the sternal body, which might indicate a retrosternal or mediastinal location of the primary disease. Thus far, only a few archaeological case studies of secondary HOA reported signs of the presumed underlying primary disease, which was of a pulmonary nature in each of the individuals.
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Affiliation(s)
- Stefan Flohr
- University of Hildesheim, Department of Biology, Universitätsplatz 1, 31141, Hildesheim, Germany.
| | - Isabelle Jasch
- Eberhard Karls University Tübingen, Institute of Prehistory, Early History and Medieval Studies, Schloss Hohentübingen, Burgsteige 11, 72070, Tübingen, Germany
| | - Antje Langer
- Eberhard Karls University Tübingen, Institute of Prehistory, Early History and Medieval Studies, Schloss Hohentübingen, Burgsteige 11, 72070, Tübingen, Germany
| | - Martin Riesenberg
- Free University of Berlin, Institute of Prehistoric Archaeology, Fabeckstraße 23-25, 14195, Berlin, Germany
| | - Julia Hahn
- Eberhard Karls University Tübingen, Institute of Prehistory, Early History and Medieval Studies, Schloss Hohentübingen, Burgsteige 11, 72070, Tübingen, Germany
| | - Axel Wisotzki
- St Bernward's Hospital, Radiological Department, Treibestraße 9, 31134 Hildesheim, Germany
| | - Horst Kierdorf
- University of Hildesheim, Department of Biology, Universitätsplatz 1, 31141, Hildesheim, Germany
| | - Uwe Kierdorf
- University of Hildesheim, Department of Biology, Universitätsplatz 1, 31141, Hildesheim, Germany
| | - Joachim Wahl
- Landesamt für Denkmalpflege im Regierungspräsidium Stuttgart, Stromeyersdorfstraße 3, 78467, Konstanz, Germany; Eberhard Karls University Tübingen, Institute for Archaeological Science, Rümelinstraße 23, 72070, Tübingen, Germany
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17
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Fang YH, Hsu CC, Hsieh MJ, Hung MS, Tsai YH, Lin YC. Impact of hypertrophic pulmonary osteoarthropathy on patients with lung cancer. Onco Targets Ther 2017; 10:5173-5177. [PMID: 29123415 PMCID: PMC5661835 DOI: 10.2147/ott.s139558] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose Hypertrophic pulmonary osteoarthropathy (HPOA) is a rare disease that most commonly occurs secondary to lung cancer. However, the clinical significance of HPOA remains unclear. The aim of this study was to evaluate the impact of HPOA on patients with lung cancer in Taiwan. Patients and methods Data regarding lung cancer patients who demonstrated findings of HPOA on bone scintigraphy between 2010 and 2016 were retrospectively analyzed. Pathological confirmation of cases was conducted at Chiayi and Kaohsiung Chang Gang Memorial Hospital. Clinical characteristics, including gender, smoking status, histology subtype, clinical stage, and epidermal growth factor receptor (EGFR) status were investigated. Results We identified 69 lung cancer patients with typical HPOA findings on bone scintigraphy. Among them, 56 were male (81.2%) and 51 were ex-smokers or current smokers (73.9%). Adenocarcinoma was the most common histology subtype (n=42, 60.9%). Of 34 patients subjected to EGFR mutation analysis, only 4 (11.8%) had EGFR-tyrosine kinase inhibitor (EGFR-TKI)-sensitive mutations. Conclusion Male, smoking, and adenocarcinoma were the most common clinical characteristics of lung cancer patients with HPOA in our cohort. However, the proportion of EGFR-TKI-sensitive mutation cases was extremely low.
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Affiliation(s)
- Yu-Hung Fang
- Department of Pulmonary and Critical Care Medicine, Division of Thoracic Oncology, Chang Gung Memorial Hospital, Puzi
| | - Chien-Chin Hsu
- Department of Nuclear Medicine, Chang Gung Memorial Hospital, Kaohsiung Branch, Kaohsiung
| | - Meng-Jer Hsieh
- Department of Respiratory Therapy, College of Medicine, Chang Gung University, Guishan.,Department of Pulmonary and Critical Care Medicine, Division of Pulmonary Infection and Critical Care Medicine, Chang Gung Memorial Hospital
| | - Ming-Szu Hung
- Department of Pulmonary and Critical Care Medicine, Division of Thoracic Oncology, Chang Gung Memorial Hospital, Puzi.,Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi.,Department of Medicine, College of Medicine, Chang Gung University, Guishan, Taiwan, Republic of China
| | - Ying-Huang Tsai
- Department of Pulmonary and Critical Care Medicine, Division of Thoracic Oncology, Chang Gung Memorial Hospital, Puzi.,Department of Respiratory Therapy, College of Medicine, Chang Gung University, Guishan
| | - Yu-Ching Lin
- Department of Pulmonary and Critical Care Medicine, Division of Thoracic Oncology, Chang Gung Memorial Hospital, Puzi.,Department of Pulmonary and Critical Care Medicine, Division of Pulmonary Infection and Critical Care Medicine, Chang Gung Memorial Hospital.,Department of Respiratory Care, Chang Gung University of Science and Technology, Puzi.,Department of Medicine, College of Medicine, Chang Gung University, Guishan, Taiwan, Republic of China
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18
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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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19
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Hypertrophic Osteoarthropathy Secondary to Lung Cancer: Beneficial Effect of Anti-vascular Endothelial Growth Factor Antibody. J Clin Rheumatol 2016; 23:47-50. [PMID: 28002159 DOI: 10.1097/rhu.0000000000000441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Yap FY, Skalski MR, Patel DB, Schein AJ, White EA, Tomasian A, Masih S, Matcuk GR. Hypertrophic Osteoarthropathy: Clinical and Imaging Features. Radiographics 2016; 37:157-195. [PMID: 27935768 DOI: 10.1148/rg.2017160052] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Hypertrophic osteoarthropathy (HOA) is a medical condition characterized by abnormal proliferation of skin and periosteal tissues involving the extremities and characterized by three clinical features: digital clubbing (also termed Hippocratic fingers), periostosis of tubular bones, and synovial effusions. HOA can be a primary entity, known as pachydermoperiostosis, or can be secondary to extraskeletal conditions, with different prognoses and management implications for each. There is a high association between secondary HOA and malignancy, especially non-small cell lung cancer. In such cases, it can be considered a form of paraneoplastic syndrome. The most prevalent secondary causes of HOA are pulmonary in origin, which is why this condition was formerly referred to as hypertrophic pulmonary osteoarthropathy. HOA can also be associated with pleural, mediastinal, and cardiovascular causes, as well as extrathoracic conditions such as gastrointestinal tumors and infections, cirrhosis, and inflammatory bowel disease. Although the skeletal manifestations of HOA are most commonly detected with radiography, abnormalities can also be identified with other modalities such as computed tomography, magnetic resonance imaging, and bone scintigraphy. The authors summarize the pathogenesis, classification, causes, and symptoms and signs of HOA, including the genetics underlying the primary form (pachydermoperiostosis); describe key findings of HOA found at various imaging modalities, with examples of underlying causative conditions; and discuss features differentiating HOA from other causes of multifocal periostitis, such as thyroid acropachy, hypervitaminosis A, chronic venous insufficiency, voriconazole-induced periostitis, progressive diaphyseal dysplasia, and neoplastic causes such as lymphoma. ©RSNA, 2016.
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Affiliation(s)
- Felix Y Yap
- From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.)
| | - Matthew R Skalski
- From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.)
| | - Dakshesh B Patel
- From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.)
| | - Aaron J Schein
- From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.)
| | - Eric A White
- From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.)
| | - Anderanik Tomasian
- From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.)
| | - Sulabha Masih
- From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.)
| | - George R Matcuk
- From the Department of Radiology, Keck School of Medicine, University of Southern California, 1500 San Pablo St, 2nd Floor Imaging, Los Angeles, CA 90033 (F.Y.Y., D.B.P., A.J.S., E.A.W., A.T., G.R.M.); Department of Radiology, Southern California University of Health Sciences, Whittier, Calif (M.R.S.); and Department of Radiology, Greater Los Angeles Veterans Affairs Medical Center, Los Angeles, Calif (S.M.)
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Yamakawa H, Sekine A, Kato T, Yamanaka Y, Hagiwara E, Umeda S, Ogura T. A case of severe arthralgia with malignant mesothelioma‐associated hypertrophic osteoarthropathy. Clin Case Rep 2016; 4:1057-1060. [PMID: 27830073 PMCID: PMC5093163 DOI: 10.1002/ccr3.709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 07/28/2016] [Accepted: 09/11/2016] [Indexed: 11/13/2022] Open
Abstract
Hypertrophic osteoarthropathy (HOA) is a rare syndrome characterized by the abnormal proliferation of dermato‐osseous tissue. We report a rare case of malignant mesothelioma‐associated HOA who suffered from refractory painful osteoarthropathy. HOA can be associated with malignant mesothelioma and that may be resistant to any treatment.
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Affiliation(s)
- Hideaki Yamakawa
- Department of Respiratory Medicine Kanagawa Cardiovascular and Respiratory Center Yokohama Japan
- Department of Respiratory Medicine Tokyo Jikei University Hospital Tokyo Japan
| | - Akimasa Sekine
- Department of Respiratory Medicine Kanagawa Cardiovascular and Respiratory Center Yokohama Japan
| | - Terufumi Kato
- Department of Respiratory Medicine Kanagawa Cardiovascular and Respiratory Center Yokohama Japan
| | - Yumie Yamanaka
- Department of Respiratory Medicine Kanagawa Cardiovascular and Respiratory Center Yokohama Japan
- Department of Respiratory Medicine Tokyo Jikei University Hospital Tokyo Japan
| | - Eri Hagiwara
- Department of Respiratory Medicine Kanagawa Cardiovascular and Respiratory Center Yokohama Japan
| | - Shigeaki Umeda
- Department of Pathobiology Yokohama City University Graduate School of Medicine Yokohama Japan
| | - Takashi Ogura
- Department of Respiratory Medicine Kanagawa Cardiovascular and Respiratory Center Yokohama Japan
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22
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Paraneoplastic syndrome demonstrated on 99mTc-HMDP bone scan. Eur J Nucl Med Mol Imaging 2016; 43:2271-2272. [PMID: 27511189 DOI: 10.1007/s00259-016-3471-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 07/18/2016] [Indexed: 10/21/2022]
Abstract
A 23-year-old man, with no relevant medical history, presented with inflammatory peripheral and axial polyarthritis, wrist pain, and persistent low-grade fever for the past 4 months. A bone scintigraphy showed intense periosteal early and delayed uptake in long bones, with normal uptake in the spine, pelvis, and rib cage, and no clear focus of hypermetabolism. CT scan revealed a mediastinal mass. A biopsy of the mass demonstrated Hodgkin lymphoma with bulky disease. This paraneoplastic syndrome as the first sign of intrathoracic Hodgkin's disease is rare.
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24
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González-Reimers E, Trujillo-Mederos A, Machado-Calvo M, Castañeyra-Ruiz M, Ordóñez AC, Arnay-de-la-Rosa M. A skeletal case of hypertrophic osteoarthropathy from the Canary Islands dating from 1000 BP. INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2015; 11:1-6. [PMID: 28802962 DOI: 10.1016/j.ijpp.2015.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 07/10/2015] [Accepted: 07/15/2015] [Indexed: 06/07/2023]
Abstract
A left tibia, the distal right tibia, and the proximal four fifths of the right ulna and radius, probably belonging to an adult prehispanic man (antiquity of ≈1000 years BP) were found among commingled bone remains in a collective burial cave of the island of El Hierro, in the Canary Archipelago. All four bones show an intense periosteal bone formation, encrusting the preserved cortical bone of the diaphyses. Differential diagnosis include melorheostosis, syphilis, and leprosy, although the most likely diagnosis is hypertrophic osteoarthropathy, which is usually associated with lung neoplasm or non-malignant diseases leading to chronic hypoxemia. The marked bone proliferation, possibly due to a chronic condition, suggests that possibly the underlying illness was a non-malignant one.
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Affiliation(s)
- Emilio González-Reimers
- Departamento de Medicina Interna, Hospital Universitario de Canarias, 38320, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain.
| | - Aioze Trujillo-Mederos
- Departamento de Geografía e Historia, Universidad de La Laguna, Tenerife, Canary Islands, Spain
| | - Manuel Machado-Calvo
- Departamento de Radiología, Hospital Universitario de Canarias, 38320, Universidad de La Laguna, La Laguna, Tenerife, Canary Islands, Spain
| | - María Castañeyra-Ruiz
- Departamento de Anatomía y Anatomía Patológica, Universidad de La Laguna, Tenerife, Canary Islands, Spain
| | - Alejandra C Ordóñez
- Departamento de Geografía e Historia, Universidad de La Laguna, Tenerife, Canary Islands, Spain
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Pourmorteza M, Baumrucker SJ, Al-Sheyyab A, Da Silva MACP. Hypertrophic Pulmonary Osteoarthropathy: A Rare But Treatable Condition in Palliative Medicine. J Pain Symptom Manage 2015; 50:263-7. [PMID: 25701054 DOI: 10.1016/j.jpainsymman.2015.02.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Revised: 02/02/2015] [Accepted: 02/11/2015] [Indexed: 11/22/2022]
Affiliation(s)
- Mehdi Pourmorteza
- Department of Internal Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, USA
| | - Steven J Baumrucker
- Wellmont Cancer Institute, Wellmont Health System, Kingsport, Tennessee, USA.
| | - Ahmed Al-Sheyyab
- Department of Internal Medicine, James H. Quillen College of Medicine, East Tennessee State University, Johnson City, Tennessee, USA
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26
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Horacio MC, María VG, Alonso GL. Hypertrophic osteoarthropathy as a complication of pulmonary tuberculosis. ACTA ACUST UNITED AC 2015; 11:255-7. [DOI: 10.1016/j.reuma.2014.10.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Revised: 10/15/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022]
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27
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Komatsu M, Yasuo M, Kobayashi N, Tateishi K, Ushiki A, Urushihata K, Yamamoto H, Hanaoka M, Matoba H, Honda T, Ichikawa K. Hypertrophic Pulmonary Osteoarthropathy in Anaplastic Lymphoma Kinase (ALK)-positive Lung Cancer. Intern Med 2015; 54:2045-9. [PMID: 26278300 DOI: 10.2169/internalmedicine.54.4452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
A 49-year-old man was admitted to a hospital with chest pain and polyarthralgia. Chest radiography showed abnormal findings, and chest computed tomography showed a mass in the right lung. A transbronchial lung biopsy led to a diagnosis of anaplastic lymphoma kinase (ALK)-positive adenocarcinoma. Bone scintigraphy revealed bilateral symmetrical accumulations of (99m)Technetium complexes in the long bones, suggesting co-existing hypertrophic pulmonary osteoarthropathy (HPO). The patient underwent four courses of chemotherapy with cisplatin plus pemetrexed, which led to decreased (99m)Technetium accumulations in the long bones. To the best of our knowledge, this is the first reported case of HPO associated with ALK-positive lung cancer.
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Affiliation(s)
- Masamichi Komatsu
- The First Department of Internal Medicine, Shinshu University School of Medicine, Japan
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28
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Touraine S, Wybier M, Sibileau E, Genah I, Petrover D, Parlier-Cuau C, Bousson V, Laredo JD. Non-traumatic calcifications/ossifications of the bone surface and soft tissues of the wrist, hand and fingers: a diagnostic approach. Diagn Interv Imaging 2014; 95:1035-44. [PMID: 25224813 DOI: 10.1016/j.diii.2014.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In the absence of obvious trauma, the calcifications/ossifications of the bone surface and soft tissues of the wrist, hand and fingers can be challenging and may not be noticed or lead to unnecessary examinations and monitoring. Although these are usually benign conditions and despite a favorable spontaneous outcome, surgical resection may be required and recurrence may occur. In practice, only paraneoplastic syndromes such as secondary hypertrophic osteoarthropathy (Pierre Marie-Bamberger syndrome) may reveal a malignant tumor, most often pulmonary. We suggest a diagnostic approach based on the initial clinical presentation (acute pain, chronic pain, growth±pain) and the radiological features.
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Affiliation(s)
- S Touraine
- Radiologie ostéo-articulaire, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France.
| | - M Wybier
- Radiologie ostéo-articulaire, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Imagerie médicale Léonard-de-Vinci, 43, rue Cortambert, 75016 Paris, France
| | - E Sibileau
- Radiologie ostéo-articulaire, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France
| | - I Genah
- Radiologie ostéo-articulaire, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France
| | - D Petrover
- Radiologie ostéo-articulaire, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France; Centre d'imagerie Bachaumont, 6, rue Bachaumont, 75002 Paris, France
| | - C Parlier-Cuau
- Radiologie ostéo-articulaire, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France
| | - V Bousson
- Radiologie ostéo-articulaire, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France
| | - J-D Laredo
- Radiologie ostéo-articulaire, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75475 Paris cedex 10, France
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Kanaji N, Watanabe N, Kita N, Bandoh S, Tadokoro A, Ishii T, Dobashi H, Matsunaga T. Paraneoplastic syndromes associated with lung cancer. World J Clin Oncol 2014; 5:197-223. [PMID: 25114839 PMCID: PMC4127595 DOI: 10.5306/wjco.v5.i3.197] [Citation(s) in RCA: 121] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2013] [Revised: 04/12/2014] [Accepted: 05/29/2014] [Indexed: 02/06/2023] Open
Abstract
Paraneoplastic syndromes are signs or symptoms that occur as a result of organ or tissue damage at locations remote from the site of the primary tumor or metastases. Paraneoplastic syndromes associated with lung cancer can impair various organ functions and include neurologic, endocrine, dermatologic, rheumatologic, hematologic, and ophthalmological syndromes, as well as glomerulopathy and coagulopathy (Trousseau’s syndrome). The histological type of lung cancer is generally dependent on the associated syndrome, the two most common of which are humoral hypercalcemia of malignancy in squamous cell carcinoma and the syndrome of inappropriate antidiuretic hormone secretion in small cell lung cancer. The symptoms often precede the diagnosis of the associated lung cancer, especially when the symptoms are neurologic or dermatologic. The proposed mechanisms of paraneoplastic processes include the aberrant release of humoral mediators, such as hormones and hormone-like peptides, cytokines, and antibodies. Treating the underlying cancer is generally the most effective therapy for paraneoplastic syndromes, and treatment soon after symptom onset appears to offer the best potential for symptom improvement. In this article, we review the diagnosis, potential mechanisms, and treatments of a wide variety of paraneoplastic syndromes associated with lung cancer.
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30
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Rhee SM, Park KJ, Ha YC. Hypertrophic osteoarthropathy in patient with Crohn's disease: a case report. J Bone Metab 2014; 21:151-4. [PMID: 25025001 PMCID: PMC4075269 DOI: 10.11005/jbm.2014.21.2.151] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2014] [Revised: 04/04/2014] [Accepted: 04/07/2014] [Indexed: 11/26/2022] Open
Abstract
Numerous causes of hypertrophic osteoarthropathy (HOA) have been reported. Commonly, secondary osteoarthropathy accompanies pulmonary diseases such as carcinoma of the lung, pleural tumors, lung abscesses, and bronchiectasis. However, HOA in inflammatory bowel disease is a rare complication. There are only a few reports of secondary HOA with Crohn's disease. Our purpose was to report another case of HOA in Crohn's disease. We describe a case of a 27-year-old man with underlying Crohn's disease presenting with 2 years of pain in multiple joints. Radiographic findings suggested HOA in extremities. We performed a conservative treatment including medication and rehabilitations. The patient's symptoms were much improved at the latest follow-up. Although numerous studies on HOA have been published, the pathogenesis of HOA is still unclear. Various treatment modalities were recommended but further studies to uncover the pathogenesis of HOA with Crohn's disease and to establish a treatment modality are needed.
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Affiliation(s)
- Sung-Min Rhee
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Ki Jeong Park
- Department of Radiology, Chung-Ang University College of Medicine, Seoul, Korea
| | - Yong-Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
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31
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Erken E, Köroğlu Ç, Yıldız F, Özer HTE, Gülek B, Tolun A. A novel recessive 15-hydroxyprostaglandin dehydrogenase mutation in a family with primary hypertrophic osteoarthropathy. Mod Rheumatol 2014; 25:315-21. [DOI: 10.3109/14397595.2013.874757] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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32
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Jung SY, Lee DW, Gu MG, Kwon TH, Ko SA, Choi JH, Sohn JW, Hyun MS. Recurrent acinic cell carcinoma in the parotid gland with cardiac metastasis and hypertrophic osteoarthropathy. Yeungnam Univ J Med 2014. [DOI: 10.12701/yujm.2014.31.1.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sung Yun Jung
- Division of Hematology-Oncolog and Cardiologyy, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Dong Won Lee
- Division of Hematology-Oncolog and Cardiologyy, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Min Geun Gu
- Division of Hematology-Oncolog and Cardiologyy, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Tae Hun Kwon
- Division of Hematology-Oncolog and Cardiologyy, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Sung Ae Ko
- Division of Hematology-Oncolog and Cardiologyy, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Joon Hyuk Choi
- Department of Pathology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Jang Won Sohn
- Division of Hematology-Oncolog and Cardiologyy, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Myung Soo Hyun
- Division of Hematology-Oncolog and Cardiologyy, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea
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33
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Erken E, Köroğlu Ç, Yıldız F, Özer HTE, Gülek B, Tolun A. A novel recessive 15-hydroxyprostaglandin dehydrogenase mutation in a family with primary hypertrophic osteoarthropathy. Mod Rheumatol 2013. [DOI: 10.1007/s10165-013-0882-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Withers SS, Johnson EG, Culp WTN, Rodriguez CO, Skorupski KA, Rebhun RB. Paraneoplastic hypertrophic osteopathy in 30 dogs. Vet Comp Oncol 2013; 13:157-65. [PMID: 23489591 DOI: 10.1111/vco.12026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Revised: 02/02/2013] [Accepted: 02/04/2013] [Indexed: 01/31/2023]
Abstract
Paraneoplastic hypertrophic osteopathy (pHO) is known to occur in both canine and human cancer patients. While the pathology of pHO is well-described in the dog, very little information exists regarding the true clinical presentation of dogs affected with pHO. The primary objective of this study was to provide a more comprehensive clinical picture of pHO. To this end, we retrospectively identified 30 dogs and recorded data regarding presenting complaints and physical examination (PE) findings on the date of pHO diagnosis. As a secondary objective, any blood test results were also collected from the computerized records. The most common clinical signs included leg swelling, ocular discharge and/or episcleral injection, lameness, and lethargy. The most common haematological and serum biochemical abnormalities included anaemia, neutrophilia and elevated alkaline phosphatase. In addition to presenting a more detailed clinical description of pHO in the dog, these data support the previously described haematological, serum biochemical and PE abnormalities published in individual case reports.
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Affiliation(s)
- S S Withers
- William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - E G Johnson
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - W T N Culp
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - C O Rodriguez
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - K A Skorupski
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
| | - R B Rebhun
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA, USA
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Pineda C, Martínez-Lavín M. Hypertrophic osteoarthropathy: what a rheumatologist should know about this uncommon condition. Rheum Dis Clin North Am 2013; 39:383-400. [PMID: 23597970 DOI: 10.1016/j.rdc.2013.02.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This article presents an updated overview of hypertrophic osteoarthropathy and digital clubbing for the practicing rheumatologist. Discussion includes a brief historical perspective, its definition, incidence and prevalence, classification, pathology and pathophysiology, clinical manifestations, demographics, findings on physical examination, imaging techniques for its detection, differential diagnosis, and treatment modalities.
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Affiliation(s)
- Carlos Pineda
- Instituto Nacional de Rehabilitación, Calzada Mexico-Xochimilco 289, Col. Arenal de Guadalupe, Mexico City 14389, Mexico.
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Abstract
Digital clubbing is an ancient and important clinical signs in medicine. Although clubbed fingers are mostly asymptomatic, it often predicts the presence of some dreaded underlying diseases. Its exact pathogenesis is not known, but platelet-derived growth factor and vascular endothelial growth factor are recently incriminated in its causation. The association of digital clubbing with various disease processes and its clinical implications are discussed in this review.
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Affiliation(s)
- Malay Sarkar
- Department of Pulmonary Medicine, Indira Gandhi Medical College, Shimla, India
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37
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Bailly F, Petrover D, Allez M, Richette P. Periostitis in a patient with inflammatory bowel disease. J Rheumatol 2012; 39:2179-80. [PMID: 23118281 DOI: 10.3899/jrheum.120672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Florian Bailly
- Hôpital Lariboisière, Pôle Appareil Locomoteur, Fédération de Rhumatologie, Universite Paris Diderot, France
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38
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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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39
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Drakonaki EE, Bradley KM, Khan ZA, Patel C, Wilson DJ. Hypertrophic osteoarthropathy in a child due to thoracic Hodgkin's disease. Skeletal Radiol 2012; 41:1027-8. [PMID: 22095020 DOI: 10.1007/s00256-011-1317-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 09/28/2011] [Accepted: 10/19/2011] [Indexed: 02/02/2023]
Affiliation(s)
- Eleni E Drakonaki
- Department of Radiology, Nuffield Orthopaedic Centre, John Radcliff Hospitals NHS Trust, Headington, Oxford, UK.
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40
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Pushpa G, Subashini K, Murali N, Rajagopalan V. Primary pachydermoperiostosis with hypertrophic gastropathy and a sliding hiatal hernia. Int J Dermatol 2012; 51:969-72. [DOI: 10.1111/j.1365-4632.2011.05106.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Davis MC, Sherry V. Hypertrophic osteoarthropathy as a clinical manifestation of lung cancer. Clin J Oncol Nurs 2012; 15:561-3. [PMID: 21951743 DOI: 10.1188/11.cjon.561-563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Hypertrophic osteoarthropathy is a paraneoplastic syndrome most often found in non-small cell lung cancer. Diagnosis is confirmed by the presence of clubbing on physical examination and periostitis on bone scintigram, and the syndrome generally resolves with treatment of the underlying malignancy. This article presents a case study and describes symptom management options, including nonsteroidal anti-inflammatory agents, octreotide, and bisphosphonates.
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Marengo MF, Suarez-Almazor ME, Lu H. Neoplastic and Paraneoplastic Synovitis. Rheum Dis Clin North Am 2011; 37:551-72. [DOI: 10.1016/j.rdc.2011.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Kilaru M, Vitale C, Montagnini M. Pain management in hypertrophic pulmonary osteoarthropathy: an illustrative case and review. Am J Hosp Palliat Care 2011; 29:302-7. [PMID: 21998443 DOI: 10.1177/1049909111421608] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Hypertrophic pulmonary osteoarthropathy (HOA) is a condition associated with lung cancer and many other diseases. Pain associated with HOA can be disabling, unremitting, and refractory to conventional analgesic medications. We present a challenging case of HOA in a patient with nonsmall cell lung cancer and review specific therapies for management of HOA-related pain.
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Affiliation(s)
- Malathy Kilaru
- Henry Ford Hospice, Henry Ford Health System, Detroit, MI, USA
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Pachydermatoglyphie associée à une ostéoarthropathie hypertrophique révélant un carcinome neuroendocrine du poumon. Ann Dermatol Venereol 2011; 138:668-72. [DOI: 10.1016/j.annder.2011.03.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2011] [Revised: 03/17/2011] [Accepted: 03/23/2011] [Indexed: 12/14/2022]
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Esophageal adenocarcinoma and hypertrophic osteoarthropathy with improvement following resection of esophageal cancer. J Clin Rheumatol 2011; 17:323-4. [PMID: 21869707 DOI: 10.1097/rhu.0b013e31822e0642] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Esophageal cancer usually presents late and carries a grave prognosis. Early diagnosis dramatically improves outcomes, and hence recognition of the varied presenting features, including hypertrophic osteoarthropathy (HOA), may be important. Hypertrophic osteoarthropathy is a rare manifestation of esophageal adenocarcinoma and indeed may herald the presence of this neoplasm, as it did in the case we present. A 59-year-old man presented with signs and symptoms suggestive of inflammatory wrist, ankle, and knee arthritis, and imaging revealed changes of HOA. He reported dysphagia mainly to solids, and endoscopic biopsy showed adenocarcinoma. Cancer resection treatment led to clinical resolution of his musculoskeletal symptoms. This case highlights the importance of recognition of HOA as a feature of this increasingly common cancer.
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Gasparyan AY, Ayvazyan L, Blackmore H, Kitas GD. Writing a narrative biomedical review: considerations for authors, peer reviewers, and editors. Rheumatol Int 2011; 31:1409-17. [PMID: 21800117 DOI: 10.1007/s00296-011-1999-3] [Citation(s) in RCA: 436] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2011] [Accepted: 07/10/2011] [Indexed: 12/20/2022]
Abstract
Review articles comprehensively covering a specific topic are crucial for successful research and academic projects. Most editors consider review articles for special and regular issues of journals. Writing a review requires deep knowledge and understanding of a field. The aim of this review is to analyze the main steps in writing a narrative biomedical review and to consider points that may increase the chances of success. We performed a comprehensive search through MEDLINE, EMBASE, Scopus, and Web of Science using the following keywords: review of the literature, narrative review, title, abstract, authorship, ethics, peer review, research methods, medical writing, scientific writing, and writing standards. Opinions expressed in the review are also based on personal experience as authors, peer reviewers, and editors.
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Affiliation(s)
- Armen Yuri Gasparyan
- Department of Rheumatology, Clinical Research Unit, Dudley Group of Hospitals NHS Foundation Trust (Teaching Trust of University of Birmingham, UK), Russell's Hall Hospital, North Block, Dudley, West Midlands, DY1 2HQ, United Kingdom.
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Jayakar BA, Abelson AG, Yao Q. Treatment of hypertrophic osteoarthropathy with zoledronic acid: case report and review of the literature. Semin Arthritis Rheum 2011; 41:291-6. [PMID: 21435696 DOI: 10.1016/j.semarthrit.2011.01.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2010] [Revised: 01/27/2011] [Accepted: 01/27/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Zoledronic acid (ZA) is rarely used to manage hypertrophic osteoarthropathy (HOA). We report our experience with ZA treatment of a patient with HOA and sarcoidosis who had also undergone lung transplant. We also conducted a literature review of the usefulness of bisphosphonates in HOA. METHODS We performed a PubMed literature search using keywords HOA, periostitis, bisphosphonate, ZA, sarcoidosis, and lung transplant. A PRISMA flow diagram is presented to depict the data collection process, and a case is reported. RESULTS A 62-year-old woman with bilateral lung transplant as a result of severe pulmonary sarcoidosis developed severe limb pain and inflammatory polyarthritis. HOA was diagnosed in the presence of periostitis with the symptoms. Failure of the refractory bone and joint pain to respond to low doses of prednisone, tramadol, or even pamidronate infusion prompted a trial of a single dose of intravenous ZA. Surprisingly, the pain completely resolved without recurrence. A total of 12 cases of HOA treated with bisphosphonates were retrieved from the literature and reviewed. CONCLUSIONS Bisphosphonates are generally effective therapy for HOA-related pain. ZA may be even more efficacious and longer lasting than pamidronate for management of the bone and joint pain associated with HOA irrespective of the underlying disorders.
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Affiliation(s)
- Bijal A Jayakar
- Department of Rheumatic and Immunologic Diseases, Orthopedic and Rheumatic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
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49
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Medication-induced periostitis in lung transplant patients: periostitis deformans revisited. Skeletal Radiol 2011; 40:143-8. [PMID: 20652242 DOI: 10.1007/s00256-010-0997-y] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 06/27/2010] [Accepted: 06/30/2010] [Indexed: 02/02/2023]
Abstract
We report five cases of diffuse periostitis resembling hypertrophic osteoarthropathy and perostitis deformans in lung transplantation patients on chronic voriconazole, a fluoride-containing compound. Although drug-related periostitis has long been known, the association of lung transplant medication with periostitis was only recently introduced in the literature. To our knowledge, imaging findings have not been fully characterized in the radiology literature. Imaging features along with clinical history help to distinguish this benign condition from other disease entities. In this article, we review the current literature and illustrate the variety of imaging characteristics of this entity so that interpreting radiologists can make accurate diagnoses and avoid unnecessary work up.
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50
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Review of current therapies for secondary hypertrophic pulmonary osteoarthropathy. Clin Rheumatol 2010; 30:7-13. [PMID: 20936419 DOI: 10.1007/s10067-010-1563-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 08/30/2010] [Indexed: 10/19/2022]
Abstract
Hypertrophic osteoarthropathy (HOA) is a disabling condition that may occur secondarily to primary lung cancer. It is characterized by digital clubbing, arthralgia/arthritis, and periostosis of the tubular bones. The pain associated with HOA can be disabling and often refractory to conventional analgesics. We performed a comprehensive review of the literature using the PubMed database on treatment modalities available for HOA. We found 52 relevant articles-40 case reports, six case series, two review papers, and four combined case series and review papers. There were no randomized controlled trials reported. We then classified treatments used for HOA into two categories: (1) treatment of primary cause (i.e., resection of tumor, chemotherapy, radiotherapy, treatment of infection, etc.) and (2) symptomatic treatments (i.e., bisphosphonates, octreotide, NSAIDs, vagotomy, etc.). Subsequently, we summarized the main findings for each treatment. Although the clinical diagnosis of HOA has existed for over 100 years, the pathogenesis mechanism has not yet been elucidated, and treatment options for this condition remain experimental. Primary treatment is the most widely reported modality to be efficacious. In cases which primary therapy is not possible, several symptomatic treatment modalities are suggested, with various degree of success. Further research is needed to clarify the pathophysiological mechanism of HOA as to appropriately direct therapy.
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