Clubbed Digits Presumably Caused by Lubiprostone.
Clubbed Digits Presumably Caused by Lubiprostone.
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DOI：
10.2169/internalmedicine.6104-20
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Kumagi T
中科院分区：
文献类型：
--
作者：
Kawamoto R;Kikuchi A;Ninomiya D;Kumagi T
数字俱乐部已被认为是一个重要的医学标志。一名33岁的女性，没有肝，肺或恶性疾病的历史被转介到我们的医院。她每天服用鲁比前列酮治疗便秘已经三年了。大约两年前，她的上肢和下肢开始逐渐出现俱乐部症状。实验室检查结果几乎正常。我们怀疑杵状指是鲁比前列酮的副作用，并证实尿前列腺素E2（PGE 2）水平升高，这可能导致杵状指。因此，我们指导该女性停止服用鲁比前列酮，并监测该实验室值。然而，该值在2个月内继续上升至41.9 μg/g Cr。在此期间，她一直服用番泻苷A B钙，而不是鲁比前列酮治疗便秘。由于番泻苷A B钙也有增加PGE 2的作用，我们下令停药。她的尿PGE 2与肌酸酐水平恢复正常，停用这两种药物后，杵状变有所改善。
Digital clubbing has been regarded as an important sign in medicine. A 33-year-old woman with no history of hepatic, pulmonary, or malignant disease was referred to our hospital. She had been taking lubiprostone every day for three years for constipation. Clubbing in her upper and lower limb digits began gradually about two years ago. The results of laboratory investigations were almost normal. We suspected the clubbed digits were a side effect of lubiprostone and confirmed that the levels of urinary prostaglandin E2 (PGE2), which can cause clubbed digits, were elevated. Thus, we instructed the woman to stop taking lubiprostone and monitored this lab value. However, the value continued to rise over 2 months to 41.9 μg/g Cr. During that time, she had been taking sennoside A B calcium instead of lubiprostone for constipation. Since sennoside A B calcium also has the effect of increasing PGE2, we ordered the discontinuation. Her urinary PGE2 to creatinine level normalized, and the clubbing improved after the discontinuation of these two medications.
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