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• W2055095052 abstract "A 62-year-old female life-long nonsmoker was referred to our department for investigation of persistent cough, weight loss, mild anaemia and gross finger clubbing. Her chest radiograph was essentially normal, computed tomographic imaging showed no significant abnormality and no endobronchial lesion was demonstrated during bronchoscopy. Her case notes became available only following her admission and it was discovered that finger clubbing had been documented 20 years earlier. She had a long history of abdominal pain and intermittent diarrhoea and had undergone numerous gastrointestinal investigations. Sigmoidoscopy 27 years earlier had demonstrated biopsy-proven melanosis coli and, combined with the finding of low potassium, suggested purgative abuse as a cause of her intestinal symptoms. During other admissions spanning several decades, her potassium was intermittently found to be low and urine had proven positive for anthraquinones. Her husband had confirmed an unusually large intake of laxatives by his wife, although this had been denied by the patient herself. During her admission for respiratory investigations, she was using laxatives (lactulose and senna) on a daily basis and despite mild chronic renal failure, her serum potassium was only 2.8 mmol l−1. Finger clubbing is associated with a wide range of pulmonary and nonpulmonary conditions and frequently raises the possibility of a serious underlying disorder. The mechanism behind its development remains uncertain, although it can disappear after successful treatment of a given disorder. We feel that congenital finger clubbing was unlikely in this patient, as its presence was noted repeatedly in the notes 20 years prior to her current admission, but not so in many entries before this. In conclusion, our case complements the paucity of literature describing chronic laxative abuse as being a cause of finger clubbing [1-4] and illustrates that this knowledge may in turn avoid unnecessary investigations. Moreover, in patients where no cause of finger clubbing has been identified, clinical features suggesting laxative abuse should be actively sought." @default.
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• W2055095052 date "2006-08-16" @default.
• W2055095052 modified "2023-10-16" @default.
• W2055095052 title "A rare cause of finger clubbing in a life-long nonsmoker" @default.
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• W2055095052 doi "https://doi.org/10.1111/j.1365-2125.2006.02750.x" @default.
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