Hypertrophic Osteoarthropathy in Patient with Crohn's Disease: A Case Report

Abstract

Numerous causes of hypertrophic osteoarthropathy (HOA) have been reported. Commonly, secondary osteoarthropathy accompanies pulmonary diseases such as carcinoma of the lung, pleural tumors, lung abscesses, and bronchiectasis. However, HOA in inflammatory bowel disease is a rare complication. There are only a few reports of secondary HOA with Crohn's disease. Our purpose was to report another case of HOA in Crohn's disease. We describe a case of a 27-year-old man with underlying Crohn's disease presenting with 2 years of pain in multiple joints. Radiographic findings suggested HOA in extremities. We performed a conservative treatment including medication and rehabilitations. The patient's symptoms were much improved at the latest follow-up. Although numerous studies on HOA have been published, the pathogenesis of HOA is still unclear. Various treatment modalities were recommended but further studies to uncover the pathogenesis of HOA with Crohn's disease and to establish a treatment modality are needed.

Inhibition of 5‐Lipoxygenase‐Derived Leukotrienes and Hemiketals as a Novel Anti‐Inflammatory Mechanism of Urolithins

“…The intestine is not an isolated system, and IBD is frequently related to extra‐intestinal manifestations, including colitis‐associated musculoskeletal manifestations and hypertrophic osteoarthropathy. [ 4,44,45 ] Based on the anti‐inflammatory activity reported for circulating phase‐II metabolites of Uro, [ 46 ] we tested whether conjugated metabolites could modulate the formation of COX‐2, 5‐LOX, and 5‐LOX/COX‐2 metabolites. However, the treatment with Uro‐A 3‐glur, Uro‐A 3‐sulf, IsoUro‐A 3‐glur, and Uro‐B 3‐glur exerted no effect on eicosanoid production.…”

Inflammatory bowel disease‐related periostosis

“…Periosteal reaction is a rare rheumatic manifestation of inflammatory bowel disease (IBD) 1 . To the best of our knowledge, bone resorption has not been reported as a rheumatic change secondary to IBD.…”

Beyond the Bowel: Extraintestinal Manifestations of Inflammatory Bowel Disease

“…Hypertrophic Osteoarthropathy.-IBD is a rare cause of secondary hypertrophic osteoarthropathy, which manifests as periosteal new bone formation, digital clubbing, and joint pain (Fig 24). The pathogenesis is thought to involve increased levels of prostaglandin E 2 , platelet-derived growth factor, and vascular endothelial growth factor (89). Hypertrophic osteoarthropathy is highly associated with malignancy, especially lung cancer.…”