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Digital Clubbing (Causes (Respiratory (Chronic suppurative lung disease,…
Digital Clubbing
Causes
Respiratory
Chronic suppurative lung disease
CF / bronchiectasis
Abscess
Empyema
Malignancy: adenocarcinoma or mesothelioma
Pulmonary fibrosis
Gastrointestinal
CLD: esp. PBC
IBD: esp. Crohn’s
Coeliac disease
GI lymphoma
Cardiac
Infective endocarditis
Congenital cyanotic heart disease
Fallot’s
Transposition
Atrial myxoma: e.g. in Carney Complex
Miscellaneous
Familial
Thyroid acropachy
Axillary artery aneurysms and brachial AVMs
Stages
1: bogginess of the nail bed
2: loss of the nail angle
3: ↑ curvature
4: expansion of the distal phalanx
Pathophysiology
Exact aetiology unknown
Platelet clumps and megakaryocytes bypass the lungs
and impact in digital capillaries.
They release growth factors such as PDGF → clubbing