Exploring the Cause of the Most Ancient Clinical Sign of Medicine: Finger Clubbing
Section snippets
Data Source
PubMed database (www.pubmed.gov) was accessed. In clinical queries/clinical study service we entered “clubbing” or “hypertrophic osteoarthropathy,” choosing the “etiology” category with a “broad sensitive” search scope. The time span was from January 1975 to August 2006.
Data Extraction
All abstracts were reviewed. All studies that contained original data were selected, reviewed, and included in the discussion.
Results
Our PubMed search on the etiology of clubbing and HOA with the above-mentioned method yielded 165
Discussion
VEGF in the epicenter of clubbing/HOA could explain how different hypoxic or malignant diseases could induce the acropachy. As already stated, VEGF is a platelet-derived factor induced by hypoxia. Also, it is abnormally produced by diverse malignant tumors fostering their uncontrolled growth (20, 21). The multiple diseases associated with clubbing/HOA have in common the presence of prominent platelet and/or endothelial cell activation. In practically all of them enhanced VEGF expression has
Acknowledgments
I gratefully thank the many Rheumatology fellows in training that through the years took the initiative with enthusiasm and were key elements for the development of research protocols. Special recognition to my colleague Carlos Pineda, who was fundamental in the elaboration of the morphological studies.
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