Abstract
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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Spicknall KE, Zirwas MJ, English JC 3rd (2005) Clubbing: an update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance. J Am Acad Dermatol 52:1020–1028. doi:10.1016/j.jaad.2005.01.006
McKinsey DS, Ratts TE, Bisno AL (1987) Underlying cardiac lesions in adults with infective endocarditis. Am J Med 82:681–688. doi:10.1016/0002-9343(87)90001-5
Bashore TM, Cabell C, Fowler V Jr (2006) Update on infective endocarditis. Curr Probl Cardiol 31(4):274–352. doi:10.1016/j.cpcardiol.2005.12.001
Mauri L, de Lemos JA, O’Gara PT (2001) Infective endocarditis. Curr Probl Cardiol 26(9):562–610. doi:10.1053/cd.2001.v26.a118054
Vandemergel X, Renneboog B (2008) Prevalence, aetiologies and significance of clubbing in a department of general internal medicine. Eur J Intern Med. doi:10.1016/j.ejim.2007.05.015
Schamroth L (1976) Personal experience. S Afr Med J 50:297–300
Martínez-Lavín M (1987) Digital clubbing and hypertrophic ostearthropathy: a unifying hypothesis. J Rheumatol 14:6–8
Atkinson S, Fox SB (2004) Vascular endothelial growth factor (VEGF)-A and platelet-derived growth factor (PDGF) play a central role in the pathogenesis of digital clubbing. J Pathol 203:721–728. doi:10.1002/path.1565
Lemen RJ, Gates AJ, Mathe AA, Waring WW, Hyman AL, Kadowitz PD (1978) Relationships among digital clubbing, disease severity, and serum prostaglandins F2alpha and E concentrations in cystic fibrosis patients. Am Rev Respir Dis 117:639–646
Hirakata Y, Kitamura S (1996) Elevated serum transforming growth factor beta 1 level in primary lung cancer patients with finger clubbing. Eur J Clin Invest 26:820–823. doi:10.1046/j.1365-2362.1996.2260560.x
Siahanidou T, Nikolaidou P, Doudounakis S, Georgouli E, Papadimitriou A, Karpathios T (2000) Plasma immunoreactive endothelin levels in children with cystic fibrosis. Acta Paediatr 89:915–920. doi:10.1080/080352500750043332
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Özdemir, B., Şentürk, T., Kaderli, A.A. et al. Postoperative regression of clubbing at an unexpected rate in a patient with aortic and mitral valve replacement due to infective endocarditis. Ir J Med Sci 178, 351–353 (2009). https://doi.org/10.1007/s11845-008-0231-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11845-008-0231-2