HİPERTROFİK OSTEOARTROPATİ: OLGU SUNUMU

Yıl 2016, Cilt: 1 Sayı: 1, 16 - 23, 01.09.2016

Cem Erçalık , Göksel Çelebi Bilge Düden Hüseyin Elik David Ojalvo Figen Yılmaz Jülide Öncü , Gülgün Durlanık Beril Doğu , Banu Kuran Fatih Borlu

Öz

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.

Anahtar Kelimeler

Hipertrofik Osteoartropati, çomak parmak, kemik sintigrafisi

HYPERTROPHIC OSTEOARTHROPATHY: A CASE REPORT

Öz

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. 

Anahtar Kelimeler

Hypertrophic osteoarthropathy, finger clubbing, bone scintigraphy

Kaynakça

• 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. 23
• 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,