title: Digital clubbing as an unusual complication of the secondary hyperparathyroidism associated with atypical neutrophils: a case report.
abstract: 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.
authors.affiliation: Department of Rheumatology and Clinical Immunology, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina.
authors.forename: N
authors.initials: N
authors.lastname: Prodanovic
authors.forename: Z
authors.initials: Z
authors.lastname: Spiric
authors.forename: G
authors.initials: G
authors.lastname: Trninic
authors.forename: M
authors.initials: M
authors.lastname: Eric
mesh_terms: D000328:Adult; D003594:Cytoplasmic Granules / Q000473:pathology; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000150:complications*; D009504:Neutrophils / Q000473:pathology*; D010005:Osteoarthropathy, Secondary Hypertrophic / Q000209:etiology*