The aetiology of clubbing and hypertrophic osteoarthropathy
TLDR
A preliminary histological report of platelet clumps seen at necropsy in nail bed capillaries of clubbed fingers supports the hypothesis that clubbing and hypertrophic osteoarthropathy are due to the peripheral impaction of megakaryocytes and plateletClumps in the fingers and toes.Abstract:
The evidence is reviewed for the hypothesis that clubbing and hypertrophic osteoarthropathy are due to the peripheral impaction of megakaryocytes and platelet clumps in the fingers and toes, to which this particulate matter has passed in an axial stream. The normal pulmonary vascular bed retains these large particles, which fragment before entering the systemic circulation. A right-to-left shunt allows them to bypass the pulmonary vascular bed. A preliminary histological report of platelet clumps seen at necropsy in nail bed capillaries of clubbed fingers supports the hypothesis. Platelets contain and release platelet-derived growth factor, whose known effects could explain all the pathological changes in clubbing. In addition to explaining why clubbing should occur in cyanotic congenital heart disease, clubbing in sub-acute bacterial endocarditis and distal to infected arterial grafts and aneurysms can be understood in terms of platelet clumps breaking off valves or arterial walls, and passing distally. Clubbing in liver disease is associated with multiple small pulmonary arteriovenous anastomoses which allow large particles through. Hypertrophic osteoarthropathy probably shares the same mechanism, and is mainly attributable to PDGF release; but there may also be altered platelet function and an additional growth factor derived from the lungs.read more
Citations
More filters
Journal ArticleDOI
Pulmonary Veno-occlusive Disease: A Case Series and New Observations
TL;DR: In this paper, the authors describe their experience at one institution with pulmonary veno-occlusive disease (PVOD) during the past 10 years, with particular reference to newfindings and long-term outcome.
Journal ArticleDOI
Platelet Production in the Pulmonary Capillary Bed: New Ultrastructural Evidence for an Old Concept
TL;DR: In this paper, it was shown that platelet release from megakaryocytes occurs in the lungs during stimulated as well as reactive thrombocytosis without precluding observations that some "proplatelets" form in the sinusoids of the bone marrow before transmigration of intact megakaries into the circulation.
Journal ArticleDOI
Cutaneous paraneoplastic syndromes in solid tumors.
Razelle Kurzrock,Philip R. Cohen +1 more
TL;DR: Cutaneous paraneoplastic syndromes are specific constellations of mucous membrane and/or skin abnormalities that are caused by an underlying tumor and may be the presenting sign of an occult cancer.
Journal ArticleDOI
The rational clinical examination. Does this patient have clubbing
Kathryn A. Myers,Donald Farquhar +1 more
TL;DR: The profile angle and phalangeal depth ratio are recommended as quantitative indices in identifying clubbing and should be used in determining the extent of further evaluation for underlying disease.
Journal ArticleDOI
Pathogenesis of thrombocytopenia in cyanotic congenital heart disease.
TL;DR: Platelet counts in CCHD appear to represent a continuum beginning with low normal counts and ending with thrombocytopenia, and it is hypothesized that right-to-left shunts deliver whole megakaryocytes into the system arterial circulation, bypassing the lungs where megakARYocytic cytoplasm is fragmented into platelets, thus reducing platelet production.
References
More filters
Journal ArticleDOI
A Platelet-Dependent Serum Factor That Stimulates the Proliferation of Arterial Smooth Muscle Cells In Vitro
TL;DR: Much of the growth-promoting activity of dialyzed serum is directly or indirectly derived from platelets, which has important implications for the response of arteries to localized injury and provides a key to further understanding of the role of factors derived from blood serum in promoting cell proliferation in vitro.
Book
Fetal and Neonatal Physiology
TL;DR: Genetics embryology the placenta developmental pharmacology and pharmacokinetics intrauterine growth postnatal growth and nutrition lipid metabolism in the foetus and newborn carbohydrate metabolism protein metabolism thermo regulation skin foetal and neonatal cardiovascular physiology.
Journal ArticleDOI
Platelets as a source of fibroblast growth-promoting activity.
Nancy Kohler,Allan Lipton +1 more
TL;DR: Evidence is presented that platelets are an enriched source of growth-promoting activity for 3T3 cells, an established line of mouse fibroblasts, and this increased activity is at least partly due to the release of a growth- Promoting activity from platelets disrupted during the clotting process.
Journal ArticleDOI
Isolation of a novel receptor cDNA establishes the existence of two PDGF receptor genes.
Toshimitsu Matsui,M. A. Heidaran,Toru Miki,Nicholas C. Popescu,W La Rochelle,Matthias H. Kraus,Jacalyn H. Pierce,Stuart A. Aaronson +7 more
TL;DR: The existence of genes encoding two PDGF receptors that interact in a distinct manner with three different PDGF isoforms likely confers considerable regulatory flexibility in the functional responses to PDGF.
Journal ArticleDOI
Platelet alpha-granule proteins: studies on release and subcellular localization
TL;DR: In this article, the characteristics of platelet proteins and 14C-serotonin (14C-5HT) were studied and compared with secretion of acid hydrolases as described by others.
Related Papers (5)
Megakaryocytes and platelet clumps as the cause of finger clubbing.
C.J. Dickinson,J.F. Martin +1 more