Secondary HOA is associated with underlying cardiopulmonary diseases and malignancies, thyroid acropachy
, acromegaly, and chronic inflammatory rheumatic diseases.
In addition, there was a mildly enlarged painless thyroid gland, with a slight hand tremor, but no signs of thyroid acropachy
or thyroid eye disease.
Barluenga, "Hypertrophic osteopathy and acropachy
associated with noncirrhotic alcoholic liver disease.
One patient (case 3) had impaired T-cell function with weight loss, hepatosplenomegaly, acropachy
, and rash.
* Pretibial myxedema, acropachy
, alopecia, onycholysis and sometimes paralysis
Hyperthyroidism with periodic paralysis, acropachy
, pre-tibial myxoedema, transient atrial fibrillation and myopathy.
In the literature we rarely see thyroid acropachy
cases with thinkenings on acral regions, normal radiography concurently; or cases without other symptoms and signs of Graves' disease.
Graves' disease (GD) is an organ-specific autoimmune disorder characterized by hyperthyroidism with diffuse goiter and a possible presence of extra-thyroid manifestations such as eye changes (thyroid ophthalmopathy), skin change (dermopathy) and fingertips change (acropachy
) [1, 2].
They cover signs and symptoms; the genetic, immune system, and environmental aspects of pathology in hyperthyroid disorders; coexisting conditions like nodular disease and vitamin B12 deficiency; conventional treatments; alternative and complementary therapies; hyperthyroidism in pregnancy, the postpartum period, and children and adolescents; and Graves' ophthalmopathy and other extrathyroidal manifestations, such as euthyroid Graves' disease, pretibial myxedema, and thyroid acropachy
Other manifestations include dermopathy, present in 1-2% of patients, affecting pretibial area, feet or areas of injury.8 Thyroid acropachy
noted in (less then) 1 in 1000 patients9 and other autoimmune events such as vitiligo, premature graying of hair and urticaria may be present.
The differential diagnosis includes secondary HOA, acromegaly, thyroid acropachy
and syphilitic periostitis.
In addition to the eye features, swelling can occur elsewhere for example in the skin of the shin (pretibial myxoedema) or in the finger nails (thyroid acropachy