| Autor: |
Brouwers A; Department of Internal Medicine, Gelderse Vallei Hospital, Ede, The Netherlands. ad.brouwers@chello.nl.; Wageningen, The Netherlands. ad.brouwers@chello.nl., Dingjan PG; Department of Clinical Chemistry, Gelderse Vallei Hospital, Ede, The Netherlands., Dujardin B; Department of Clinical Chemistry, Gelderse Vallei Hospital, Ede, The Netherlands.; Ede, The Netherlands., van Zoelen EJ; Department of Cell and Applied Biology Nijmegen, Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands.; Oosterbeek, The Netherlands., Lips P; Endocrine Section, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.; Amsterdam, The Netherlands., Gooren LJ; Endocrine Section, Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands.; Chiang Mai, Thailand. |
| Jazyk: |
angličtina |
| Zdroj: |
Clinical rheumatology [Clin Rheumatol] 2019 Jan; Vol. 38 (1), pp. 211-222. Date of Electronic Publication: 2018 Feb 26. |
| DOI: |
10.1007/s10067-018-4044-z |
| Abstrakt: |
It has been claimed that hyperestrogenism occurs in hypertrophic osteoarthropathy (HOA), but not in simple clubbing. However, one of our patients had simple clubbing and hyperestrogenism. We therefore measured estrogens, androgens, sex hormone-binding globulin (SHBG), and gonadotropins in five patients with HOA and in 18 patients with simple clubbing. Of the patients with HOA, 80% had a high urinary estriol concentration. In their serum, 80% had high estrone, 0% high estradiol, and 40% high SHBG. Of the patients with simple clubbing, 89% had a high urinary estriol concentration. In their serum, 76% had high estrone, 6% high estradiol, and 31% high SHBG. In all patients, urinary estriol concentration correlated positively with the degree of clubbing. Serum concentration of androstenedione, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) was mostly normal, but androstenedione concentration correlated positively with the degree of clubbing. Spider angiomas were present in 74%, palmar erythema in 39%, and gynecomastia in 9%. Urinary creatinine concentration was low in 48% and correlated positively with the degree of clubbing. We reject the claim that hyperestrogenism occurs in HOA, but not in simple clubbing. Hyperestrogenism occurs both in HOA and in simple clubbing. Our results also support earlier reports that clubbing and HOA are associated with spider angiomas, palmar erythema, gynecomastia, adrenal cortical hyperfunction, muscle atrophy, and water retention. These results led to a new hypothesis on the pathogenesis of HOA, involving estrogens, prostaglandin E 2 , prostaglandin A 2 , and the inflammatory reflex. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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