Pulmonary Hypertrophic Osteoarthropathy

Holling, H. E.

doi:10.7326/0003-4819-66-1-232

Cited by 43 publications

(13 citation statements)

References 11 publications

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“…Evidence in support of this theory is provided by the observation that vagotomy or intercostal nerve section can relieve the symptoms of HO in human patients. The blood flow to the limbs in HO has been shown to be reduced by section of the lung pedicle (Holling et al 1961) and by local anaesthetic block of the vagus in the neck (Holling ef al. 1963).…”

Section: Discussionmentioning

confidence: 99%

Hypertrophic osteopathy (Marie's disease) in Equidae: a review of twenty‐four cases

Mair

Dyson

Fraser

et al. 1996

Equine Veterinary Journal

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SummaryThe case records of 23 horses and one donkey affected by hypertrophic osteopathy (HO) (Marie's disease) were reviewed. All affected animals presented with limb swellings, which were bilaterally symmetrical and usually involved both fore-and hindlimbs. Associated signs included stiffnesdlameness and weight loss. Radiological features included perlosteal new bone formation over the diaphyses and metaphyses of affected bones. The metacarpal and metatarsal bones were most frequently affected. Articular surfaces remained free of disease. Seventeen animals were destroyed on humane grounds, 3 horses recovered after successful treatment of the primary disease, 3 horses recovered after symptomatic treatment and one horse was lost to follow-up. Significant primary diseases that were believed to predispose to HO were identified @re-or post mortem) in 14 cases.

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Section: Discussionmentioning

confidence: 99%

Hypertrophic osteopathy (Marie's disease) in Equidae: a review of twenty‐four cases

Mair

Dyson

Fraser

et al. 1996

Equine Veterinary Journal

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“…Two others had had palliative surgery in the past. The patient in whom a definite procedure was performed is described below to stress that correction of the rightto-left shunt in CCHD may improve HOA,just as does correction of other lesions known to cause HOA (12).…”

Section: Methodsmentioning

confidence: 99%

Hypertrophic osteoarthropathy in cyanotic congenital heart disease. its prevalence and relationship to bypass of the lung

Martı́nez-Lavı́n

Bobadilla

Casanova

et al. 1982

Arthritis & Rheumatism

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The frequency of hypertrophic osteoarthropathy in cyanotic congenital heart disease has previously been considered to be very low. Only a few isolated reports have described such an association. We studied 32 consecutive patients older than 6 years with various types of cyanotic congenital heart disease and examined each case for hypertrophic osteoarthropathy. We also assessed the role of the altered cardiopulmonary hemodynamics in the development of hypertrophic osteoarthropathy by means of cardiac catheterization. Our results showed that 31% of the patients had hypertrophic osteoarthropathy. When the hemodynamic parameters of the group of patients with hypertrophic osteoarthropathy were compared with those of the remaining patients, we found significant differences in the systemic blood flow (P I 0.05), right-to-left shunt (P I 0.05), and arterial oxygen unsaturation (P I 0.005). Thus, we found a much higher prevalence of hypertrophic osteoarthropathy in patients with cyanotic congenital heart disease than has previously been recognized. The development of hypertrophic osteoarthropathy is related to the degree of bypass of the lung. This is consistent with the concept that hypertrophic osteoarthropathy results from mediators in the systemic venous circulation that escape inactivation in the pulmonary capillary bed.Although digital clubbing is common in patients with cyanotic congenital heart disease (CCHD), hypertrophic osteoarthropathy (HOA) has rarely been reported in this condition. In two standard textbooks of internal medicine (1-3), the association of HOA and CCHD is given little attention. Harrison (1) mentions only in passing that HOA may occur in CCHD. Cecil (2) lists it with lung cancer, mesothelioma, and bronchiectasis, but omits mention of it with CCHD. The English language literature does contain a few isolated reports of HOA associated with CCHD (4-8). Trever (6) quoted Helen Taussig that only 3 cases of HOA were seen at the Harriet Lane Home in 3,000 patients with CCHD. It seems to us, however, that the true frequency of HOA in CCHD has never been properly assessed, since many cases may have been missed or ignored by physicians far more interested in the heart than the joints.In the present study, we investigated the prevalence of HOA in CCHD patients over 6 years old in our institution. We also assessed the role of the altered cardiopulmonary hemodynamics in the development of HOA by means of cardiac catheterization. PATIENTS AND METHODSWe studied 32 consecutive CCHD patients older than 6 years who were admitted t o our institution for evaluation of their heart conditions. The age limit was set arbitrarily; all previously reported cases were older than 6 years (4) and also, with this age limit, the clinical and x-ray assessments are more accurate. Each patient had a complete history and

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“…The neurogenic theory arose from the observations of Flavell (1956) that regression of the arthropathy occurred after section of the vagal fibres to the lung even when the bronchogenic carcinoma was not removed. Experimental evidence which partially supported Flavell's findings was put forward by Holling, Brodey, and Boland (1961);and Holling, Danielson, Hamilton, Blakemore, and Brodey (1963), who postulated that impulses arose in the vagus nerve (Holling, 1967). The efferent path of the 'reflex' did not appear to be neural but they were unable to find evidence for a simple humoral mechanism to explain the increased limb blood flow which is a constant feature in osteoarthropathy (Ginsburg, 1958;Holling et al, 1961 arising in a primary neurogenic sarcoma of the lung, and the patient's joint pains were relieved abruptly by excision of the tumour with division of the perihilar vagal nerve fibres.…”

Section: Discussionmentioning

confidence: 80%

Primary intrapulmonary neurogenic sarcoma with hypertrophic pulmonary osteoarthropathy and asbestosis

Caves

Jacques

1971

Thorax

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A case of primary intrapulmonary neurogenic sarcoma with hypertrophic pulmonary osteoarthropathy and asbestosis is described. The essential histological features of this rare tumour are detailed, and the five authentic cases previously reported are reviewed. The pathogenesis of hypertrophic pulmonary osteoarthropathy and its occurrence in this case are discussed. After surgical removal of the tumour recurrence appeared in the chest within six months. It responded poorly to radiotherapy, and death from metastases occurred 16 months after operation.

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Pulmonary Hypertrophic Osteoarthropathy

Cited by 43 publications

References 11 publications

Hypertrophic osteopathy (Marie's disease) in Equidae: a review of twenty‐four cases

Hypertrophic osteopathy (Marie's disease) in Equidae: a review of twenty‐four cases

Hypertrophic osteoarthropathy in cyanotic congenital heart disease. its prevalence and relationship to bypass of the lung

Primary intrapulmonary neurogenic sarcoma with hypertrophic pulmonary osteoarthropathy and asbestosis

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