Clubbing: Encyclopedia II - Clubbing - Disease associations

Clubbing - Disease associations

Clubbing - Isolated clubbing

Clubbing is associated with:

• Lung disease:
  • Lung cancer, mainly large-cell (35% of all cases)^[2]
  • Interstitial lung disease
  • Tuberculosis
  • Bronchiectasis
  • Suppurative lung disease: lung abscess, empyema
  • Cystic fibrosis
  • Pulmonary hypertension
  • Mesothelioma
  • Emphysema (rarely)
• Heart disease:
  • Any disease featuring chronic Hypoxia
  • congenital cyanotic heart disease (most common cardiac cause)
  • Endocarditis (not in acute cases, maybe subacute infective endocarditis)
  • Atrial myxoma (benign tumor)
• Others:
  • Crohn's disease and ulcerative colitis
  • Hyperthyroidism (thyroid acropachy)
  • Liver diseases (in the "hepatopulmonary syndrome", a complication of cirrhosis)^[3]
  • Malabsorption
  • Vascular anomalies of the affected arm (in unilateral clubbing)

Although many of these associations are recognised (such as the link with lung cancer), some are based on a few observations and might be false. Prospective studies of patients presenting with clubbing have not been performed, and hence there are no reliable numbers as to the distribution of the causes and the prognosis.

Clubbing - HPOA

A special form of clubbing is hypertrophic pulmonary osteo-arthropathy, known in continental Europe as Pierre Marie-Bamberger syndrome. This is the combination of clubbing and thickening of periosteum (connective tissue lining of the bones) and synovium (lining of joints), and is often initially diagnosed as arthritis. It is associated almost exclusively with lung cancer.

Clubbing - Primary HOA

Primary hypertrophic osteo-arthropathy is HPOA without signs of pulmonary disease. This form has a hereditary component, although subtle cardiac abnormalties can occasionally be found. It is known in continental Europe as the Touraine-Solente-Golé syndrome.

Adapted from the Wikipedia article "Disease associations", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki