Hypertrophic Pulmonary Osteoarthropathy Associated with Pulmonary Metastases Removed Surgically

Abstract

Recent investigations have added to our means of establishing the true diagnosis of pemicious aneemia. Until recently the cardinal laboratory features in pernicious anlemia were the characteiistic blood picture, megaloblastic marrow and histaminefast achlorhydria. The serum vitamin B12 level in our patient was abnormalry low; this estimation may bring to light examples of neurological disease due to vitamin B12 deficiency: this is amplified by the clinical picture resembling that of the patients reported by Jewesbury (I954). Absolute achlorhydria was confirmed by the augmented histamine test meal, and the most important feature, absence of intrinsic factor production, was confirmed by the Schilling test carried out before and after giving the patient intrinsic factor. The patient responded fully to vitamin B12 therapy. Summary Pernicious anaemia is recorded in a patient aged 24 years, presenting chiefly with neurological manifestations. The rarity of this disease in young patients is pointed out and reference is made to the literature. The importance of precise diagnosis aided by newer techniques is stressed owing to the necessary lifelong substitution therapy required.

Hypertrophic osteoarthropathy in childhood malignancy

“…In contrast to suppurative processes in the lungs, in those with neoplastic disease involving the chest, HOA may precede pulmonary symptoms by [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] months. A striking feature of HOA in these instances is the reversibility of the complaints after successful treatment of the disorder of the chest, both in benign and malignant conditions.…”

Hypertrophic pulmonary osteoarthropathy in association with pulmonary metastases from extrathoracic tumours

“…Ray and Fischer (1953) Garcia deLima(1955) Baldry (1959) Gibbs, Schiller, andStovin (1960) Alexander andJohnson (1962).. Aufses and Aufses (1960) Barres, Garetta, Quintane, and Jeantet (1962) Diner (1962).. Papavasiliou (1963).. Jaffee (1964).. Papavasiliou (1963), who commented on the young age of the patients affected, the hilar position of the pulmonary metastases, and the regression of symptoms after irradiation of the pulmonary metastases. Out of four patients with pulmonary metastases from nasopharyngeal tumours seen by the same author, three had osteoarthropathy.…”

Hypertrophic pulmonary osteoarthropathy and its occurrence with pulmonary metastases from renal carcinoma.

“…However, with the increasing incidence of bronchogenic carcinoma this has become by far the commonest cause of hypertrophic osteoarthropathy, and many reference books now omit pulmonary metastases from their list of conditions known to be associated with the syndrome (Crofton and Douglas, 1969;Cecil and Loeb, 1963). Excellent reviews by Yacoub, Simon, and Buchan and Mitchell 1967 Successive pregnancies Cullen and Maskery 1966 r Angel 1957 Idiopathic familial -Baldwin 1959L Hecht 1965 Ohnsorge (1967), Aufses and Aufses (1960), and Alexander and Johnson (1962) have recorded primary tumours the pulmonary metastases from which have been associated with hypertrophic osteoarthropathy (Table II). These include various sarcomata, carcinomata, and melanoma.…”