Clubbing--a reevaluation of its incidence and causes.

117 adult patients (age > 13 years) admitted in medical wards were studied for clubbing. 24.8% (29/117) of the patients had clubbing. Incidence of clubbing in males and females was 22.2% (26/117) and 2.6% (3/117) respectively [corrected]. Liver disease, which was seen in 27.6% cases (8/29) of clubbing, was the commonest cause of clubbing and was observed only in males. This was related to a high incidence of alcohol intake among males i.e. 34.6% (9/26) as against none among the females. Amongst the liver disease, suppurative liver disease was responsible for clubbing in 75% (6/8) of cases. Only 20.7% (6/29) of patients with clubbing had severe clubbing. 66.6% (4/6) of patients with severe clubbing had liver disease. Congenital heart disease was cause of clubbing in 2 out of 3 females (66.6%) with clubbing. Alcohol may be causally related to occurrence of clubbing in this part of the country.

Hemihipertrofia corporal asociada a artritis reumatoidea y síndrome convulsivo crónico

Se presenta el caso de un hombre de 27 años con hemihipertrofia corporal derecha que compromete cara, tronco y extremidades, asociada a artritis reumatoidea que cumplía los criterios de la ARA (American Rheumatic Association) para la entidad, y a un síndrome convulsivo tónico clónico generalizado de 20 años de evolución. La hemihipertrofia corporal que representa el agrandamiento excesivo de los constituyentes de un hemicuerpo ha sido asociada a tumores intraabdominales, malformaciones del tracto urinario, anomalías orofaciales, hemihipoestesia, hemiareflexia y retardo mental. Se han descrito casos familiares. Varias teorías se han propuesto para tratar de explicar la etiopatogénia. Este es el primer caso de hemihipertrofia corporal asociada a artritis reumatoidea y a un síndrome convulsivo crónico descrito en la literatura.