Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Subungual epidermoid inclusions are protrusions of the nail bed epithelium into the upper most bed stroma. They may be associated with hyperplasia of the bed epithelium resulting in subungual keratosis, onycholysis or even clubbing. An 11-year-old girl presented to our dermatology clinic with a one year history of progressive increase in the size of the distal part of her left thumb associated with mild pain on pressure. The diagnosis became evident perioperatively, which showed multiple subungual epidermoid inclusions.
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PMID:Subungual epidermoid inclusions. 1508 30

Hypertrophic osteoarthropathy (HOA) is one of the paraneoplastic syndromes most commonly associated with non-small-cell lung cancer. Although pulmonary metastasis is the second most common initial site of melanoma metastasis, HOA is rarely detected in patients with metastatic melanoma in the lung. We report a case of a 45-year-old woman with advanced melanoma who developed HOA after her disease had progressed through first-line systemic therapy. The patient's diagnosis of HOA was made on the basis of digital clubbing, arthralgia, pain, joint effusion and periosteal bone formation on X-ray with negative rheumatologic laboratory studies. Only six cases of HOA in metastatic melanoma have been reported previously. This diagnosis should be considered with lung metastases and the presentation of polyarthralgia with appropriate laboratory and imaging findings. Interestingly, the patient responded to bisphosphonates and second-line chemotherapy with carboplatin and paclitaxel, which is commonly used for lung cancer, not advanced melanoma. As with many paraneoplastic syndromes, successful treatment of the underlying disease was associated with a rapid resolution of the symptoms.
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PMID:Hypertrophic osteoarthropathy associated with metastatic melanoma. 1631 44

Hypertrophic osteoarthropathy (HOA) is a clinico-radiological syndrome characterized by digital clubbing, periosteal proliferation, bone pain, synovitis and arthralgia, all of these being commonly symmetrical. It is occasionally associated with nasopharyngeal lymphoepitheliomas and may develop before or after development of lung metastases in these patients. We report a case of a healthy 22-year-old female who presented to our institution with pain and swelling in the thighs and legs. She had a history of childhood nasopharyngeal lymphoepithelioma. Radiographs of the knees were negative. Magnetic resonance imaging (MRI) showed features suggestive of bilateral periostitis. Because of the propensity of the rare childhood nasopharyngeal lymphoepithelioma to present with HOA, this entity was included in the differential diagnosis. A subsequent chest radiograph and CT demonstrated a lung and mediastinal mass that were histologically confirmed to be metastatic. To the best of our knowledge, HOA and metastases from nasopharyngeal lymphoepithelioma occurring after such a long time interval have not been previously reported. Early demonstration and consideration of HOA on the basis of MRI, lead to expeditious and appropriate subsequent investigation.
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PMID:MRI diagnosis of hypertrophic osteoarthropathy from a remote childhood malignancy. 1695 48

Primary hypertrophic osteoarthropathy (HOA) is a rare cause ofjoint pain. The diagnosis is often delayed, due to mild complaints. However, finger clubbing combined with joint pain should suggest considering HOA in the diagnosis. The progression of toes and fingertips widening is slow and can be overlooked by a patient. It is common that patient seeks physician's aid only when the joint pain occurs. The presented case is an example of delayed diagnosis. Due to the fact that secondary HOA coexists with some diseases associated with serious prognosis it is recommended to exclude other possible causes before diagnosing primary HOA. Some clues, like the age of disease onset or positive family history allow the diagnosis of primary HOA with high probability. This case report contains clinical symptoms and new diagnostic criteria, differential diagnosis, and possible complications.
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PMID:[Primary hypertrophic osteoarthropathy as a rare cause of joint pain]. 1742 8

Reflex sympathetic dystrophy (RSD) is a poorly understood neurovascular disorder characterized by pain, altered sensation, motor disturbance, soft tissue changes, vasomotor changes, and autonomic changes that occurs after trauma to an extremity. Unilateral leukonychia, Beau's lines, nailfold swelling, and nail clubbing have been an observed sequela of RSD. We present a case of a unilateral atypical trachyonychia occurring in the setting of RSD after traumatic fracture of a digit.
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PMID:Unilateral trachyonychia in a patient with reflex sympathetic dystrophy. 1822 30

Thyroid acropachy is a rare complication of thyroid disease most often occurring in patients with a long history of active Graves' disease with ophthalmopathy and dermopathy already present. It presents with digital clubbing and soft tissue swelling with possible pain in the digits. Plain radiographs show a solid periosteal reaction that tends to be bilateral and generally symmetrical involving the tubular bones of the hands and feet. Treatment is directed at the thyroid dysfunction and the accompanying ophthalmopathy and dermopathy. It is important to recognize the association with a more severe ophthalmopathy. In the absence of Graves' ophthalmopathy and dermopathy, a diligent search for other causes of acropachy is warranted.
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PMID:Thyroid acropachy. 1826 60

Hypertrophic osteoarthropathy (HOA) is a syndrome characterized by digital clubbing, arthralgias, and tissue swelling and is frequently described in association with bronchogenic carcinoma. The associated pain can be disabling, and symptoms are often resistant to conventional analgesic medications. We present a patient with HOA of the lower extremities and wrists that developed after bronchogenic carcinoma. The pain and swelling completely resolved after a single administration of 4 mg of zoledronic acid. The proposed pathogenesis of HOA and the mechanisms by which bisphosphonates might alleviate symptoms are reviewed.
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PMID:Hypertrophic osteoarthropathy effectively treated with zoledronic acid. 1862 29

A 44-year-old man presented with painful swelling of wrists and ankles, severe pain at both tibiae, clubbing of fingers and toes and arthritis in wrist and ankle joints. The chest roentgenogram showed consolidation of the right lower lobe, whereas plain roentgenograms revealed solid periosteal reaction at both tibiae. CT and bronchoscopy confirmed the presence of adenocarcinoma of the right lower lobe. Moreover, mycobacterium of tuberculosis was isolated by culture of the patient's sputum.Our patient received antituberculous treatment and soon he underwent surgical excision of the tumour and subsequent chemotherapy. Ten months later, he returned with metastatic lesions in the brain and the adrenals. A few days later, he died.The patient suffered from bronchial adenocarcinoma as well as pulmonary tuberculosis. As a complication of these two coexisting conditions, the patient developed hypertrophic pulmonary osteoarthropathy.
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PMID:Hypertrophic pulmonary osteoarthropathy secondary to bronchial adenocarcinoma and coexisting pulmonary tuberculosis: a case report. 1884 Feb 65

Pulmonary diseases such as malignancies, empyema, bronchiectasis, digestive tract malignancies, inflammatory bowel diseases, cyanotic congenital heart diseases and infective endocarditis can cause clubbing. We present a 63-year-old female patient with infective endocarditis, who had clubbing that resolved very rapidly after cardiac surgery due to rupture of the mitral papillary muscle. She had persistent fever and in her echocardiographic examination rupture of the papillary muscle of the anterior mitral valve and significant aortic regurgitation was noted. She was scheduled for emergency operation and had debridement and replacement of the mitral and the aortic valves. During the follow-up, she had complaints of pain in the distal parts of the fingers. The convex shape of the nails changed and basal portions were apparently thinner and paler than the previous thickened and discoloured, hyperkeratotic nails. This newly growing tissue rapidly replaced the old thick nails in 3 days.
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PMID:Postoperative regression of clubbing at an unexpected rate in a patient with aortic and mitral valve replacement due to infective endocarditis. 1884 16

Hypertrophic osteoarthropathy (HOA) is characterized by digital clubbing, long bone periosteal reaction, and polyarthralgias. Primary familial HOA is very rare and is not associated with underlying disorders and has a good prognosis. Secondary pediatric nonneoplastic HOA is associated with cystic fibrosis, congenital heart disease, biliary atresia, and inflammatory bowel disease. Secondary neoplastic HOA may be associated with intra or extrathoracic tumors.A 5-year-old girl was admitted to our hospital for an abdominal mass, digital clubbing, and diffuse articular pain. The bone scan revealed symmetrical tracer uptake in the long bones. Upper and lower extremity x-rays were diagnostic for HOA. Paraneoplastic HOA in childhood accounts for not more than 12% of HOA paitents. HOA has been reported in 2 other cases of rhabdomyosarcoma.
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PMID:Rhabdomyosarcoma associated hypertrophic osteoarthropathy in a child: detection by bone scintigraphy. 1935 78


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