Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period.
Identifieur interne : 004422 ( PubMed/Corpus ); précédent : 004421; suivant : 004423Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period.
Auteurs : Vahab Fatourechi ; Debra D F. Ahmed ; Kara M. SchwartzSource :
- The Journal of clinical endocrinology and metabolism [ 0021-972X ] ; 2002.
English descriptors
- KwdEn :
- Adrenal Cortex Hormones (therapeutic use), Adult, Aged, Aged, 80 and over, Autoimmune Diseases (complications), Autoimmune Diseases (diagnostic imaging), Autoimmune Diseases (drug therapy), Autoimmune Diseases (physiopathology), Elephantiasis (etiology), Extremities (diagnostic imaging), Female, Graves Disease (etiology), Graves Disease (surgery), Humans, Male, Middle Aged, Myxedema (etiology), Periosteum (diagnostic imaging), Pulmonary Disease, Chronic Obstructive (complications), Radiography, Retrospective Studies, Severity of Illness Index, Smoking, Thyroid Diseases (complications), Thyroid Diseases (diagnostic imaging), Thyroid Diseases (drug therapy), Thyroid Diseases (physiopathology), Thyroid Gland (physiopathology), Time Factors, Treatment Outcome.
- MESH :
- chemical , therapeutic use : Adrenal Cortex Hormones.
- complications : Autoimmune Diseases, Pulmonary Disease, Chronic Obstructive, Thyroid Diseases.
- diagnostic imaging : Autoimmune Diseases, Extremities, Periosteum, Thyroid Diseases.
- drug therapy : Autoimmune Diseases, Thyroid Diseases.
- etiology : Elephantiasis, Graves Disease, Myxedema.
- physiopathology : Autoimmune Diseases, Thyroid Diseases, Thyroid Gland.
- surgery : Graves Disease.
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Radiography, Retrospective Studies, Severity of Illness Index, Smoking, Time Factors, Treatment Outcome.
Abstract
Thyroid acropachy is an extreme manifestation of autoimmune thyroid disease. It presents with digital clubbing, swelling of digits and toes, and periosteal reaction of extremity bones. It is almost always associated with ophthalmopathy and thyroid dermopathy. During a 26-yr period at our institution, of 178 patients with thyroid dermopathy, 40 had acropachy. Clubbing associated with thyroid dermopathy (pretibial myxedema) was seen in 35 patients. Clubbing usually was not a patient complaint and was noted only by clinical observers. Four of eight patients with hand and extremity radiographs had periosteal reaction. Seven had associated extremity and joint pain; this pain was absent at long-term follow-up. Half of the patients required systemic corticosteroid therapy, 53% required transantral or transfrontal orbital decompression for severe ophthalmopathy, and 18% had the elephantiasic form of dermopathy. Cigarette-smoking rates were 81% for women and 75% for men (mean, 28 pack-years). All 13 patients who had thyroid-stimulating Ig measurement had high titers. Long-term follow-up (median, 12.5 yr) revealed that acropachy was not a complaint in follow-up visits or questionnaires. The data suggest that thyroid acropachy is an indicator of severity of ophthalmopathy and dermopathy. It is a source of clinical concern only if dermopathy is persistent and severe.
DOI: 10.1210/jc.2002-020746
PubMed: 12466333
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pubmed:12466333Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period.</title><author><name sortKey="Fatourechi, Vahab" sort="Fatourechi, Vahab" uniqKey="Fatourechi V" first="Vahab" last="Fatourechi">Vahab Fatourechi</name><affiliation><nlm:affiliation>Division of Endocrinology, Diabetes, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. fatourechi.vahab@mayo.edu</nlm:affiliation></affiliation></author><author><name sortKey="Ahmed, Debra D F" sort="Ahmed, Debra D F" uniqKey="Ahmed D" first="Debra D F" last="Ahmed">Debra D F. Ahmed</name></author><author><name sortKey="Schwartz, Kara M" sort="Schwartz, Kara M" uniqKey="Schwartz K" first="Kara M" last="Schwartz">Kara M. Schwartz</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2002">2002</date><idno type="RBID">pubmed:12466333</idno><idno type="pmid">12466333</idno><idno type="doi">10.1210/jc.2002-020746</idno><idno type="wicri:Area/PubMed/Corpus">004422</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">004422</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period.</title><author><name sortKey="Fatourechi, Vahab" sort="Fatourechi, Vahab" uniqKey="Fatourechi V" first="Vahab" last="Fatourechi">Vahab Fatourechi</name><affiliation><nlm:affiliation>Division of Endocrinology, Diabetes, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. fatourechi.vahab@mayo.edu</nlm:affiliation></affiliation></author><author><name sortKey="Ahmed, Debra D F" sort="Ahmed, Debra D F" uniqKey="Ahmed D" first="Debra D F" last="Ahmed">Debra D F. Ahmed</name></author><author><name sortKey="Schwartz, Kara M" sort="Schwartz, Kara M" uniqKey="Schwartz K" first="Kara M" last="Schwartz">Kara M. Schwartz</name></author></analytic><series><title level="j">The Journal of clinical endocrinology and metabolism</title><idno type="ISSN">0021-972X</idno><imprint><date when="2002" type="published">2002</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adrenal Cortex Hormones (therapeutic use)</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Autoimmune Diseases (complications)</term><term>Autoimmune Diseases (diagnostic imaging)</term><term>Autoimmune Diseases (drug therapy)</term><term>Autoimmune Diseases (physiopathology)</term><term>Elephantiasis (etiology)</term><term>Extremities (diagnostic imaging)</term><term>Female</term><term>Graves Disease (etiology)</term><term>Graves Disease (surgery)</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Myxedema (etiology)</term><term>Periosteum (diagnostic imaging)</term><term>Pulmonary Disease, Chronic Obstructive (complications)</term><term>Radiography</term><term>Retrospective Studies</term><term>Severity of Illness Index</term><term>Smoking</term><term>Thyroid Diseases (complications)</term><term>Thyroid Diseases (diagnostic imaging)</term><term>Thyroid Diseases (drug therapy)</term><term>Thyroid Diseases (physiopathology)</term><term>Thyroid Gland (physiopathology)</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Adrenal Cortex Hormones</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Autoimmune Diseases</term><term>Pulmonary Disease, Chronic Obstructive</term><term>Thyroid Diseases</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Autoimmune Diseases</term><term>Extremities</term><term>Periosteum</term><term>Thyroid Diseases</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Autoimmune Diseases</term><term>Thyroid Diseases</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Elephantiasis</term><term>Graves Disease</term><term>Myxedema</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Autoimmune Diseases</term><term>Thyroid Diseases</term><term>Thyroid Gland</term></keywords><keywords scheme="MESH" qualifier="surgery" xml:lang="en"><term>Graves Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Radiography</term><term>Retrospective Studies</term><term>Severity of Illness Index</term><term>Smoking</term><term>Time Factors</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Thyroid acropachy is an extreme manifestation of autoimmune thyroid disease. It presents with digital clubbing, swelling of digits and toes, and periosteal reaction of extremity bones. It is almost always associated with ophthalmopathy and thyroid dermopathy. During a 26-yr period at our institution, of 178 patients with thyroid dermopathy, 40 had acropachy. Clubbing associated with thyroid dermopathy (pretibial myxedema) was seen in 35 patients. Clubbing usually was not a patient complaint and was noted only by clinical observers. Four of eight patients with hand and extremity radiographs had periosteal reaction. Seven had associated extremity and joint pain; this pain was absent at long-term follow-up. Half of the patients required systemic corticosteroid therapy, 53% required transantral or transfrontal orbital decompression for severe ophthalmopathy, and 18% had the elephantiasic form of dermopathy. Cigarette-smoking rates were 81% for women and 75% for men (mean, 28 pack-years). All 13 patients who had thyroid-stimulating Ig measurement had high titers. Long-term follow-up (median, 12.5 yr) revealed that acropachy was not a complaint in follow-up visits or questionnaires. The data suggest that thyroid acropachy is an indicator of severity of ophthalmopathy and dermopathy. It is a source of clinical concern only if dermopathy is persistent and severe.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">12466333</PMID><DateCreated><Year>2002</Year><Month>12</Month><Day>05</Day></DateCreated><DateCompleted><Year>2003</Year><Month>01</Month><Day>17</Day></DateCompleted><DateRevised><Year>2016</Year><Month>11</Month><Day>24</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Print">0021-972X</ISSN><JournalIssue CitedMedium="Print"><Volume>87</Volume><Issue>12</Issue><PubDate><Year>2002</Year><Month>Dec</Month></PubDate></JournalIssue><Title>The Journal of clinical endocrinology and metabolism</Title><ISOAbbreviation>J. Clin. Endocrinol. Metab.</ISOAbbreviation></Journal><ArticleTitle>Thyroid acropachy: report of 40 patients treated at a single institution in a 26-year period.</ArticleTitle><Pagination><MedlinePgn>5435-41</MedlinePgn></Pagination><Abstract><AbstractText>Thyroid acropachy is an extreme manifestation of autoimmune thyroid disease. It presents with digital clubbing, swelling of digits and toes, and periosteal reaction of extremity bones. It is almost always associated with ophthalmopathy and thyroid dermopathy. During a 26-yr period at our institution, of 178 patients with thyroid dermopathy, 40 had acropachy. Clubbing associated with thyroid dermopathy (pretibial myxedema) was seen in 35 patients. Clubbing usually was not a patient complaint and was noted only by clinical observers. Four of eight patients with hand and extremity radiographs had periosteal reaction. Seven had associated extremity and joint pain; this pain was absent at long-term follow-up. Half of the patients required systemic corticosteroid therapy, 53% required transantral or transfrontal orbital decompression for severe ophthalmopathy, and 18% had the elephantiasic form of dermopathy. Cigarette-smoking rates were 81% for women and 75% for men (mean, 28 pack-years). All 13 patients who had thyroid-stimulating Ig measurement had high titers. Long-term follow-up (median, 12.5 yr) revealed that acropachy was not a complaint in follow-up visits or questionnaires. The data suggest that thyroid acropachy is an indicator of severity of ophthalmopathy and dermopathy. It is a source of clinical concern only if dermopathy is persistent and severe.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Fatourechi</LastName><ForeName>Vahab</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Division of Endocrinology, Diabetes, Metabolism, Nutrition, and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA. fatourechi.vahab@mayo.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ahmed</LastName><ForeName>Debra D F</ForeName><Initials>DD</Initials></Author><Author ValidYN="Y"><LastName>Schwartz</LastName><ForeName>Kara M</ForeName><Initials>KM</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Clin Endocrinol 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