Digital clubbing as an unusual complication of the secondary hyperparathyroidism associated with atypical neutrophils: a case report

N. Prodanovic, Z. Spiric, G. Trninic, M. Eric

Department of Rheumatology and Clinical Immunology, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina. zorica.spiric@kc-bl.com
Department of Nuclear Medicine and Thyroid Diseases, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina
Department of Clinical Radiology, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina
Department of Anatomy, Faculty of Medicine, Novi Sad, Serbia

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• Internal Medicine

Digital clubbing is a rare clinical finding and usually represents a sign of underlying disease.

There are only few cases of digital clubbing in patients with primary hyperparathyroidism or with secondary hyperparathyroidism (SHPT) during long-term hemodialysis. We haven’t come across papers dealing with the relation of digital clubbing and SHPT caused by vitamin D deficiency.

In this article, we report a case of 43 year-old female patient with prominent clubbing of the fingers and toes, and 22 year history of SHPT caused by vitamin D deficiency. Current radiographic findings of the hands and feet are actually uncommon, and they show massive osteolytic lesions of numerous phalanges, which is the consequence of long-time untreated SHPT.

Besides, our patient has a rare case of neutrophils with bilobed nuclei and decreased cytoplasmic granularity.

This paper for the first time describes digital clubbing as an unusual complication of the SHPT caused by vitamin D deficiency associated with atypical neutrophils.

Published on: 2012/10/17

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