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Case report: hippocratic digital and Crohn's disease
K Makiyama1, K Ishida, W Zea-Iriarte
1Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Insights
This report details a rare case of finger clubbing and hypertrophic osteoarthropathy in a Japanese Crohn's disease patient. It highlights the potential role of platelets in these rare inflammatory bowel disease complications.
Area of Science:
- Gastroenterology
- Rheumatology
- Pathology
Background:
- Inflammatory bowel disease (IBD), including Crohn's disease, is associated with various extraintestinal manifestations.
- Finger clubbing (Hippocratic digital) and secondary hypertrophic osteoarthropathy are rare complications of IBD, more frequently reported in Western populations.
Observation:
- A case study of a 29-year-old Japanese male with Crohn's disease presenting with both finger clubbing and secondary hypertrophic osteoarthropathy.
- This represents the first reported instance of finger clubbing associated with Crohn's disease in Japan.
Findings:
- The co-occurrence of finger clubbing and secondary hypertrophic osteoarthropathy in Crohn's disease is exceptionally rare.
- The study discusses the pathogenesis, suggesting finger clubbing and hypertrophic osteoarthropathy may be part of a shared pathological spectrum.
Implications:
- The findings suggest a potential role for megakaryocytes or platelet aggregates in the development of these conditions.
- This case expands the known geographical and clinical spectrum of IBD-associated digital and skeletal changes.
- Further research into the role of platelet function in IBD complications is warranted.
Abstract:
A case of Hippocratic digital associated with secondary hypertrophic osteoarthropathy complicating Crohn's disease in a 29 year old Japanese male is reported. Hippocratic digital, or finger clubbing, complicating inflammatory bowel disease has been frequently reported in the Western hemisphere. However, its association with secondary hypertrophic osteoarthropathy has been very rarely found in that disease. In Japan, Hippocratic digital has not been described previously. With regard to the pathogenesis of Hippocratic digital and secondary hypertrophic osteoarthropathy, the theory that both entities belong to the same pathological spectrum and that megakaryocytes or platelet clumps may play the most important role, is discussed.