Cem ERÇALIK,
Göksel ÇELEBİ,
Bilge DÜDEN,
Hüseyin ELİK,
David OJALVO,
Figen YILMAZ,
Jülide ÖNCÜ,
Gülgün DURLANIK,
Beril DOĞU,
Banu KURAN,
Fatih BORLU
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HİPERTROFİK OSTEOARTROPATİ: OLGU SUNUMU
Hipertrofik Osteoartropati (HO) ilk defa Marie ve Bamberger tarafından 1889 yılında tanımlanmış
genellikle pulmoner hastalıklarla karakterize olan klinik bir tablodur (6). Klasik triadı; Parmaklarda
çomaklaşma, artrit ve özellikle uzun kemikleri tutan periostit ile bu bölgelerde baskın ağrıdır (18).
Laboratuvar bulguları altta yatan hastalığa göre değişmekle birlikte genellikle yüksek düzeyde saptanan
eritrosit sedimentasyon hızı (ESH) ve C-reaktif protein (CRP) şeklindedir (13). Her iki alt ekstremitede
ağrı ve sağ dirsekte şişlik şikayeti ile polikliniğimize başvuran 52 yaşındaki erkek hastanın fizik
muayenesi ve tetkikleri sonucu HO tanısı konuldu. Olgu literatür eşliğinde tartışıldı.
HYPERTROPHIC OSTEOARTHROPATHY: A CASE REPORT
Hypertrophic osteoarthropathy (HO) is a disorder which has been defined for the first time in 1889 by
Marie and Bamberger. It is usually characterized by clinical pulmonary disease (6). Classical triad includes
finger clubbing, arthritis and pain caused by periostitis especially in the long bones (18). Laboratory findings
vary according to the underlying disease and usually high levels of erythrocyte sedimentation rate
and C-reactive protein exist (13). A 52 year old male patient with bilateral lower extremity pain and swelling
in his right elbow was admitted to our hospital. After physical examination and laboratory results,
HO was diagnosed. The patient is discussed under the light of the current literature.
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- 1. Abe Y, Kurita S, Ohkubo Y, Usui H, Hashizume T, Nakamura M, Ueyama Y, Fujino T. A case of
pulmonary adenocarcinima associated with hypertrophic osteoarthropathy due to vascular endothelial
growth factor. Anticancer Res. 2002;22: 3485–3458.
- 2. Altman RD, Tenenbaum J. Hypertrophic osteoarthropathy. In: Kelley W, Harris Jr ED, Ruddy
S, Sledge C, editors. Textbook of rheumatology. 8th ed. Philadelphia WB Saunders; 2009. p. 1606–8.
- 3. Amital H, Applbaum YH, Vasiliev L, Rubinow A. Hypertrophic pulmonary osteoarthropathy:
control of pain and symptoms with pamidronate. Clin Rheumatol 2004;23: 330-2.
- 4. Awerbuch MS, Brooks PM. Role of immune complexes in hypertrophic osteoarthropathy and
nonmetastatic polyarthritis. Ann Rheum Dis. 1981;40: 470–2.
- 5. Blackwell N, Bangham L, Hughes M, Melzack D, Trotman I. Treatment of resistant pain in
hypertrophic pulmonary arthropathy with ketorolac. Thorax 1993;48: 401.
- 6. C. Cruz, M. Rocha, D. Andrade, F. Guimarães, V. Silva, S. Souza, C.A. Moura, C.G. Moura. Hypertrophic
pulmonary osteoarthropathy with positive antinuclear antibodies: case report. Case Rep Oncol
5: 308-312, 2012.
- 7. Harris AW, Harding TA, Gaitonde MD, Maxwell JD. Is clubbing a feature of the antiphospholipid
antibody syndrome? Postgrad Med J. 1993;69: 748–50.
- 8. Kishi K, Nakamura H, Sudo A, Kobayashi K, Yagyu H, Oh-ishi S, Matsuoka T. Tumor debulking
by radiofrequency ablation in hypertrophic pulmonary osteoarthropathy associated pulmonary carcinoma.
Lung Cancer. 2002;38: 317–320.
- 9. Kozak KR, Milne GL, Morrow JD, Cuiffo BP. Hypertrophic osteoarthropathy pathogenesis: a
case highlighting the potential role for cyclo-oxygenase-2-derived prostaglandin E2. Nat Clin Pract
Rheumatol 2006;2: 452-6.
- 10. Matucci-Cerinic M, Martinez-Lavin M, Rojo F, Fonseca C, Kahaleh BM. Von Willebrand factor
antigen in hypertrophic osteoarthropathy. J Rheumatol. 1992;19: 765–7.
- 11. Milman E, Berdon WE, Garvin JH, Cairo MS, Bessmertny O, Ruzal-Shapiro C. Periostitis secondary
to interleukin-11 (Oprelvekin, Neumega) Treatment for thrombocytopenia in pediatric patients.
Pediatr Radiol. 2003;33: 450–2.
- 12. Mito K, Maruyama R, Uenishi Y, et al. Hypertrophic pulmonary osteoarthropathy associated
with non-small cell lung cancer demonstrated growth hormone-releasing hormone by immunohistochemical
analysis. Intern Med. 2001;40: 532–535.
- 13. Morgan B, Coakley F, Finlay DB, Belton I. Hypertrophic osteoarthropathy in staging skeletal
scintigraphy for lung cancer. Clin Radiol. 1996;51: 694–647.
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- 14. Nomori H, Kobayashi R, Kubo A, Morinaga S, Shintani Y, Sano T . Lung cancer containing
growth hormone-releasing hormone associated with hypertrophic osteoarthropathy. Case report.
Scand J Thorac Cardiovasc Surg. 1994; 28: 149–152.
- 15. Ooi A, Saad RA, Moorjani N, Amer KM. Effective symptomatic relief of hypertrophic pulmonary
osteoarthropathy by video-assisted thoracic surgery truncal vagotomy. Ann Thorac Surg
2007;83: 684-5.
- 16. Shih WJ. Pulmonary hypertrophic osteoarthropathy and its resolution. Semin Nucl Med
2004;34: 159-63.
- 17. Silveira LH, Martínez-Lavín M, Pineda C, Fonseca MC, Navarro C, Nava A. Vascular endothelial
growth factor and hypertrophic osteoarthropathy. Clin Exp Rheumatol 2000;18: 57-62.
- 18. Vogl A, Goldfischer S. Pachydermoperiostosis. Primary or idiopathic hypertrophic osteoarthropathy.
Am J Med 1962;33: 166-87.
- 19. Yacoub MH. Cervical vagotomy for pulmonary osteoarthropathy. Br J Dis Chest. 1965;59:
28–31.
ERÇALIK, ÇELEBİ, DÜDEN, ELİK, OJALVO, YILMAZ, ÖNCÜ,