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    Clubbing in A Patient of Hypothyroidism - A Case Report

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    International Journal of Innovative Science and Research Technology
    Digital clubbing is very important and ancient clinical signs in medicine. Although most of the time clubbed fingers are asymptomatic and exact pathogenesis is not known. The Thyroid acropachy is uncommon sign of autoimmune thyroid disorders. We present a rare case of Hypothyroidism associated with clubbing. A 45 year old male with severe degree of clubbing in fingers and toes along with markedly increased thyroid stimulating hormone levels. Patient also had severe Dyslipidaemia.

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    Clubbing in A Patient of Hypothyroidism - A Case Report

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    International Journal of Innovative Science and Research Technology
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    Digital clubbing is very important and ancient clinical signs in medicine. Although most of the time clubbed fingers are asymptomatic and exact pathogenesis is not known. The Thyroid acropachy is uncommon sign of autoimmune thyroid disorders. We present a rare case of Hypothyroidism associated with clubbing. A 45 year old male with severe degree of clubbing in fingers and toes along with markedly increased thyroid stimulating hormone levels. Patient also had severe Dyslipidaemia.

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    Clubbing in a Patient of Hypothyroidism – A Case Report

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    Digital clubbing is very important and ancient clinical signs in medicine. Although most of the time clubbed fingers are asymptomatic and exact pathogenesis is not known. The Thyroid acropachy is uncommon sign of autoimmune thyroid disorders. We present a rare case of Hypothyroidism associated with clubbing. A 45 year old male with severe degree of clubbing in fingers and toes along with markedly increased thyroid stimulating hormone levels. Patient also had severe Dyslipidaemia.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    94 views2 pages

    Clubbing in A Patient of Hypothyroidism - A Case Report

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    International Journal of Innovative Science and Research Technology
    Digital clubbing is very important and ancient clinical signs in medicine. Although most of the time clubbed fingers are asymptomatic and exact pathogenesis is not known. The Thyroid acropachy is uncommon sign of autoimmune thyroid disorders. We present a rare case of Hypothyroidism associated with clubbing. A 45 year old male with severe degree of clubbing in fingers and toes along with markedly increased thyroid stimulating hormone levels. Patient also had severe Dyslipidaemia.

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    Volume 4, Issue 9, September – 2019 International Journal of Innovative Science and Research Technology

    ISSN No:-2456-2165

    Clubbing in a Patient of Hypothyroidism –


    A Case Report
    Mohammad Anas*, Ziaur Rahman*, Abul Faiz**, Jamal Azmat***
    * PG Scholar D/O Moalijat AKTC AMU ALIGARH
    ** PG Scholar D/O Kulliyat AKTC AMU ALIGARH
    ***Assistant Professor D/O Moalijat AKTC AMU ALIGARH

    Abstract: Digital clubbing is very important and ancient of all fingers and toes. There was no local tenderness present
    clinical signs in medicine. Although most of the time at wrist and ankle joint. The systemic examination of the
    clubbed fingers are asymptomatic and exact patient was normal except, presence of slow relaxation of
    pathogenesis is not known. The Thyroid acropachy is deep tendon reflexes. Routine Haematological and
    uncommon sign of autoimmune thyroid disorders. We Biochemical test were normal. Liver function test and
    present a rare case of Hypothyroidism associated with abdominal ultrasonography were normal. The thyroid profile
    clubbing. A 45 year old male with severe degree of showed Serum TSH level of 730mlU/L with normal Total
    clubbing in fingers and toes along with markedly T3 and T4 Levels. His Lipid Profile revealed serum
    increased thyroid stimulating hormone levels. Patient cholesterol 237mg/dl, Triglycerides 411mg/dl, HDL
    also had severe Dyslipidaemia. Patient was managed 24mg/dl. R.A factor was negative. A diagnosis of acropachy
    with L-Thyroxine and Atorvastatin, Finofibrates showed with hypothyroidism was made, Patient was started on L-
    marked improvement in symptoms. Thyroxine with Atorvastatin and finofibrates5.Within a
    period of few months patient showed marked improvement
    Keywords:- Clubbing, Acropachy, Hypothyroidism. in his symptoms.

    I. INTRODUCTION Thyroid acropachy is commonly seen in patients who


    have Hyperthyroidism2,3,4,6-10. The pattern of changes in
    Clubbing of finger is described as bulbous acropachy is characteristic occurs at mid shaft of tubular
    enlargement of soft parts of the terminal phalanges that are bones with an adjacent soft tissue proliferation3,4,6. In Our
    usually associated with both transverse and longitudinal patient similar pattern was seen, there was no local
    curving of the nails. The swelling of the terminal phalanges tenderness as seen in hypertrophic osteoarthopathy.
    occur due to the interstitial oedema and dilation of the Pulmonary osteoarthropathy is important differential
    arterioles and capillaries.1 Acropachy in hypothyroidism is diagnosis but there was no Pulmonary pathology detected in
    the rare cause of Digital clubbing. The images of rare case our patient. Hypothyroidism is the rarest cause of digital
    of clubbing in hypothyroidism are presented. clubbing.

    III. DISCUSSION

    Thyroid Acropachy is usually present in patients of


    thyroid dysfunction that is hyperthyroidism, dermopathy,
    and severe degree of ophthalmopathy2,3,4 but in our case
    report clubbing is present in fingers and toes with severe
    degree of hypothyroidism. It is rare but important cause of
    clubbing11.

    REFERENCES

    [1]. Mehta’s P.J. ‘Practical of Medicine’ 20th Edition 2017.


    Page Number 15-16.
    Fig 1:- (Image of Finger Clubbing) [2]. Fauci A. S. et al., ‘Harrison's Principles of Internal
    Medicine’, 18th Edition McGraw Hill, 2012; Vol: 2, P:
    II. CASE REPORT 2911-23.
    [3]. Walker B. R., Colledge N. R., Ralston S. H. and
    A 45 years old gentleman presented with hoarseness of Penman I. D., ‘Davidson's Principles & Practice of
    voice, generalized Oedema from last one year. He also Medicine’, 21nd Edition, Churchill Livingstone
    complained of swelling of fingers of hands and toes from Elsevier, 2014; P: 737-48.
    same duration. He had a past history of intake of thyroid [4]. Munjal Y. P. et al., ‘API Textbook of Medicine’, 9th
    hormone replacement therapy three years back. There was Edition, Jaypee Brothers Medical Publishers (P) Ltd.,
    no other significant history. On Physical Examination, the 2012; Vol: 1 , P: 419-29.
    thyroid gland was not palpable but he had severe clubbing

    IJISRT19SEP1412 www.ijisrt.com 777


    Volume 4, Issue 9, September – 2019 International Journal of Innovative Science and Research Technology
    ISSN No:-2456-2165
    [5]. Tripathi K. D., ‘Essentials of Medical Pharmacology’,
    7th edition; 2014; Jaypee Brothers Medical Publishers
    (P) Ltd., New Delhi; P: 245-258.
    [6]. Humes HD. ‘Kelly’s Textbook of Internal Medicine’,
    4th ed. USA: Lippincott Williams & Wilkins, 2000; P:
    2695,2710.
    [7]. Alagappan R., ‘Manual of Practical Medicine’, 5th
    Edition, Jaypee Brothers Medical Publishers (P) Ltd.,
    2014; P: 765-75.
    [8]. Golwalla A. F. and Golwalla S. A., ‘Medicine for
    Students’, A reference book for the Family Physician,
    24th Edition, National Book Depot, Mumbai, 2014; P:
    318-34.
    [9]. Kumar and Clark M., ‘Kumar & Clark Clinical
    Medicine’, 7th Edition Saunders, 2009; P: 984-92.
    [10]. Pavan B, Alexandra D, Mark G, “The Washington
    Manual of Medical Therapeutics” 35th Edition,
    Pubished by Wolter Kluwer 2016. Page 758-66.
    [11]. Fatourechi V, Ahmed DDE, Schwartz KM. Thyroid
    acropachy: Report of 40 patients treated at a single
    institute in a 26 year period. J Clin Endocrinol Metab
    2002;87:5435-41.

    IJISRT19SEP1412 www.ijisrt.com 778

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