Painful Clubbing and Sarcoidosis

Abstract

ACQUIRED clubbing, particularly when painful, has long been recognized as an important physical finding often associated with an underlying disease. Detailed reviews have listed numerous pulmonary, cardiac, hepatic, gastrointestinal (GI), and endocrinologic diseases as causes of acquired symmetrical clubbing. 1,2 Notably absent from this list is sarcoidosis, which is a systemic disease known frequently to affect all these organ systems simultaneously. We report herein sarcoidosis associated with painful clubbing of all fingers and toes. Of interest also was the dramatic relief of pain and stiffness achieved with colchicine therapy. Report of a Case A 28-year-old man was seen at the medical clinic with a three-year history of migratory polyarthralgias and an 18-month history of painful clubbing of fingers and toes. Associated symptoms included malaise, generalized weakness, low-grade fever, 7-kg weight loss, nonproductive cough with dyspnea on exertion, and one episode of painful nodules on the anterior aspect of his shins.