[A rare cause of Pierre Marie hypertrophic osteoarthropathy: subacute infectious endocarditis].
Secondary hypertrophic osteoarthropathy occurred in a patient with subacute endocarditis. Chest x-ray in this smoker with ethylic cirrhosis showed a pulmonary opacity. Clinical signs of osteoarthropathic inflammation resolved with antibiotics before surgical cure of the aortic insufficiency. The diagnosis was retained on the basis of outcome after antibiotic therapy and the absence of any other etiology, notably bronchogenic cancer. Endocarditis or infectious endarteritis should be entertained in case of hypertrophic osteoarthropathy in patients with an infectious syndrome. Pathogenic hypotheses are discussed. In congenital cardiopathies, intrapulmonary shunts, megacaryocytes and activation of the vascular-platelet endothelium unit may be involved. Bacterial factors and platelet aggregation could play a role in initiating hypertrophic osteoarthropathy in patients with infectious endocarditis.
Urban
T
T
Service de Pneumologie, Hôpital Saint-Antione, Paris.
Rozenstajn
L
L
Lebeau
B
B
D001792:Blood Platelets / Q000502:physiology; D016207:Cytokines / Q000502:physiology; D004698:Endocarditis, Subacute Bacterial / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D004730:Endothelium, Vascular / Q000502:physiology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008297:Male; D008875:Middle Aged; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D012907:Smoking
D016207:Cytokines