Pulmonary Hypertrophic Osteoarthropathy

Abstract

A adoloscent with history of severe food allergies requiring oral immunotherapy, iron deficiency anemia, and eczema presented to the rheumatology clinic with a two-month history of lower ex-tremity joint swelling and extreme fatigue following minimal exertion. The physical exam was notable for knee and ankle joint effusions with tenderness to palpation. Clubbing of the fingers and toes was present bilaterally. Laboratory evaluation revealed elevated erythrocyte sedi-mentation rate, C-reactive protein, and serum IgA. Notable negative labs included complete blood count, comprehensive metabolic panel, antinuclear antibody, Lyme disease, and rheumatoid factor.