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==Overview==
==Overview==
Life threatening causes of clubbing include [[lung cancer]], [[tetralogy of fallot]], [[transposition of great vessels]], and [[tricuspid atresia]]. Other common causes of clubbing are [[bronchiectasis]], [[cystic fibrosis]],  [[cirrhosis]], and  [[empyema]].
==Causes==
==Causes==
===Life Threatening Causes===
===Life Threatening Causes===
*[[Aneurysm]]
*[[Lung cancer]]
*[[Tetralogy of Fallot]]
*[[Transposition of the great vessels]]
*[[Tricuspid atresia]]
*[[Truncus arteriosus]]


===Common Causes===
===Common Causes===
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{|style="width: 80%; height: 100px; text-align: justify; text-justify: distribute;" border="1"
{|style="width: 80%; height: 100px; text-align: justify; text-justify: distribute;" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[ Aneurysm]], [[arterial vascular prosthesis infections]], [[arteriovenous fistula]], [[arteriovenous malformations]], [[atrial myxoma]], [[atrial septal defect]], [[cerebrovascular insult]], [[hypoxia|chronic hypoxia]], [[common ventricle]], [[Congenital heart disease|congenital cardiovascular malformations]], [[congestive heart failure]],  [[Congenital heart disease cyanotic|cyanotic congenital heart disease]], [[Congenital heart disease|conotruncal heart malformations]], [[double outlet right ventricle]], [[Eisenmenger syndrome]], [[endocarditis]], [[ erythromelalgia ]], [[patent ductus arteriosus]], [[Pulmonary hypertension|pulmonary thromboembolic hypertension]], [[Right-to-left shunt|right-to-left shunting]], [[subacute bacterial endocarditis]], [[Taussig-Bing syndrome]], [[tetralogy of fallot]], [[total anomalous pulmonary venous connection]], [[transposition of the great vessels]], [[tricuspid atresia]], [[truncus arteriosus]],  [[pulmonic stenosis]] [[heart cancer]], [[ventricular septal defect]].  
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[ Aneurysm]], [[arterial vascular prosthesis infections]], [[arteriovenous fistula]], [[arteriovenous malformations]], [[atrial myxoma]], [[atrial septal defect]], [[cerebrovascular insult]], [[hypoxia|chronic hypoxia]], [[common ventricle]], [[Congenital heart disease|congenital cardiovascular malformations]], [[congestive heart failure]],  [[Congenital heart disease cyanotic|cyanotic congenital heart disease]], [[Congenital heart disease|conotruncal heart malformations]], [[double outlet right ventricle]], [[Eisenmenger syndrome]], [[endocarditis]], [[ erythromelalgia ]], [[patent ductus arteriosus]], [[Pulmonary hypertension|pulmonary thromboembolic hypertension]], [[Right-to-left shunt|right-to-left shunting]], [[subacute bacterial endocarditis]], [[Taussig-Bing syndrome]], [[tetralogy of fallot]], [[total anomalous pulmonary venous connection]], [[transposition of the great vessels]], [[tricuspid atresia]], [[truncus arteriosus]],  [[pulmonic stenosis]], [[heart cancer]], [[ventricular septal defect]].  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Achalasia]],[[celiac sprue]], [[Chronic liver disease]], [[Obstructive jaundice |chronic obstructive jaundice]], [[Cirrhosis|Cirrhosis of  liver]], [[Crohn disease]], [[cystic fibrosis]], [[Gastrointestinal cancer|gastrointestinal neoplasms]], [[hepatoma]], [[hepatopulmonary syndrome]], [[Inflammatory bowel disease]], [[Leiomyoma|Leiomyoma of the esophagus]], [[Liver Cancer |liver tumors]], [[malabsorption]], [[oesophageal cancer]], [[Peutz-Jeghers syndrome]], [[primary biliary cirrhosis]], [[small bowel lymphoma]], [[stomach cancer]], [[ulcerative colitis]], [[Whipple disease]],
|bgcolor="Beige"| [[Achalasia]],[[celiac sprue]], [[chronic liver disease]], [[obstructive jaundice |chronic obstructive jaundice]], [[Cirrhosis|cirrhosis of  liver]], [[Crohn disease]], [[cystic fibrosis]], [[Gastrointestinal cancer|gastrointestinal neoplasms]], [[hepatoma]], [[hepatopulmonary syndrome]], [[Inflammatory bowel disease]], [[Leiomyoma|leiomyoma of the esophagus]], [[Liver Cancer |liver tumors]], [[malabsorption]], [[oesophageal cancer]], [[Peutz-Jeghers syndrome]], [[primary biliary cirrhosis]], [[small bowel lymphoma]], [[stomach cancer]], [[ulcerative colitis]], [[Whipple disease]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"|[[Arteriovenous malformations]], [[arteriovenous shunts]], [[atrial septal defect]], [[Celiac disease]], [[Congenital heart disease|congenital cardiovascular malformations]], [[Cyanotic heart disease|congenital cyanotic heart disease]], [[Congenital heart disease|conotruncal heart malformations]], [[congenital heart disease]], [[crohn's disease]], [[Cystic fibrosis]], [[Situs inversus |dextrocardia-bronchiectasis-sinusitis]], [[Ebstein's anomaly]], [[Eisenmenger syndrome]],  [[Peutz-Jeghers Syndrome]], [[Taussig-Bing syndrome ]], [[hereditary haemorrhagic telangiectasia]], [[Ivemark syndrome]], [[Jansen's metaphyseal chondrodysplasia ]], [[pachydermoperiostosis]], [[patent ductus arteriosus]], [[tetralogy of fallot]]
|bgcolor="Beige|[[Celiac disease]], [[crohn's disease]], [[Cystic fibrosis]], [[Situs inversus |dextrocardia-bronchiectasis-sinusitis]], [[Ebstein's anomaly]], [[Eisenmenger syndrome]],  [[Peutz-Jeghers Syndrome]], [[Taussig-Bing syndrome ]], [[hereditary haemorrhagic telangiectasia]], [[Ivemark syndrome]], [[Jansen's metaphyseal chondrodysplasia ]], [[pachydermoperiostosis]]  
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"| [[Cannabis]]
|bgcolor="Beige"|No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Musculoskeletal / Ortho'''
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Jansen's metaphyseal chondrodysplasia]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
| '''Nutritional / Metabolic'''
|bgcolor="Beige"| No underlying causes
|bgcolor="Beige"| [[Celiac sprue]], [[cystic fibrosis]]
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Thyroid cancer]], [[Thymus cancer]], [[Hodgkin's disease]], [[POEMS syndrome]], [[Metastatic]] [[melanoma]], [[Mesothelioma]], [[Nasopharyngeal carcinoma]], [[Myelofibrosis]], [[Atrial myxoma]],   
|bgcolor="Beige"| [[Atrial myxoma]], [[bronchial carcinoma]], [[Hodgkin's disease]], [[lung cancer]], [[mesothelioma]], [[melanoma|metastatic  melanoma]], [[myelofibrosis ]], [[nasopharyngeal carcinoma]], [[pancoast tumor]], [[pleural fibroma]], [[pleural mesothelioma]],[[POEMS syndrome]], [[Stomach cancer]]
|-
[[thyroid cancer]], [[thymus cancer]]
  |-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
| '''Opthalmologic'''
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|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"|[[Asbestosis]], [[Asthma|asthma complicated by infection]], [[berylliosis]],[[bronchial carcinoma]],[[bronchiectasis]], [[bronchiolitis obliterans]], [[bronchogenic carcinoma]], [[hypoxia|chronic hypoxia]],[[chronic obstructive pulmonary disease ]],[[cryptogenic fibrosing alveolitis]],[[cystic fibrosis]], [[emphysema]],[[empyema]],[[extrathoracic disease]], [[extrinsic allergic alveolitis]], [[Interstitial fibrosis |familial interstitial fibrosis]], [[pulmonary arterial hypertension |familial pulmonary arterial hypertension]], [[fibrosing alveolitis]], [[Hamman-Rich Syndrome ]], [[hepatopulmonary syndrome]], [[hypersensitivity pneumonitis]],[[hypertrophic pulmonary osteoarthropathy]], [[Diffuse interstitial fibrosis|idiopathic diffuse interstitial fibrosis]], [[idiopathic pulmonary fibrosis]], [[idiopathic pulmonary haemosiderosis]], [[idiopathic pulmonary hypertension ]], [[interstitial fibrosis]], [[interstitial lung disease]],[[interstitial pneumonitis]], [[Interstitial lung disease |interstitial pulmonary fibrosis]], [[lipoid pneumonia]],[[lung cancer]], [[Hypertrophic osteoarthropathy|Marie-bamberg syndrome]],[[pancoast tumor]], [[pleural fibroma]], [[pleural mesothelioma]],[[polyarteritis nodosa]],[[primary pulmonary hypertension]], [[pulmonary abscess]], [[pulmonary alveolar proteinosis]], [[pulmonary arteriovenous malformation]], [[pulmonary artery sarcoma]],[[pulmonary artery sclerosis]], [[pulmonary fibrosis]], [[Granuloma|pulmonary granuloma]], [[pulmonary hypertension]], [[Pulmonary hypertension |pulmonary hypoxic hypertension]], [[Lymphoma|pulmonary lymphoma]], [[pulmonary metastases]], [[Pulmonary surfactant-associated protein B|pulmonary surfactant protein b, deficiency]], [[Pulmonary hypertension|pulmonary thromboembolic hypertension]], [[pulmonary tuberculosis]], [[pulmonic stenosis]], [[sarcoidosis]], [[Secondary pulmonary hypertension]], [[silicosis]], [[Pulmonary surfactant|surfactant metabolism dysfunction]].
|bgcolor="Beige"|[[Asbestosis]], [[Asthma|asthma complicated by infection]], [[berylliosis]],[[bronchial carcinoma]],[[bronchiectasis]], [[bronchiolitis obliterans]], [[bronchogenic carcinoma]], [[hypoxia|chronic hypoxia]],[[chronic obstructive pulmonary disease ]],[[cryptogenic fibrosing alveolitis]],[[cystic fibrosis]], [[emphysema]],[[empyema]],[[extrathoracic disease]], [[extrinsic allergic alveolitis]], [[Interstitial fibrosis |familial interstitial fibrosis]], [[pulmonary arterial hypertension |familial pulmonary arterial hypertension]], [[fibrosing alveolitis]], [[Hamman-Rich Syndrome ]], [[hepatopulmonary syndrome]], [[hypersensitivity pneumonitis]],[[hypertrophic pulmonary osteoarthropathy]], [[Diffuse interstitial fibrosis|idiopathic diffuse interstitial fibrosis]], [[idiopathic pulmonary fibrosis]], [[idiopathic pulmonary haemosiderosis]], [[idiopathic pulmonary hypertension ]], [[interstitial fibrosis]], [[interstitial lung disease]],[[interstitial pneumonitis]], [[lipoid pneumonia]],[[lung cancer]], [[Hypertrophic osteoarthropathy|Marie-bamberg syndrome]],[[pancoast tumor]], [[pleural fibroma]], [[pleural mesothelioma]],[[polyarteritis nodosa]],[[primary pulmonary hypertension]], [[pulmonary abscess]], [[pulmonary alveolar proteinosis]], [[pulmonary arteriovenous malformation]], [[pulmonary artery sarcoma]],[[pulmonary artery sclerosis]], [[pulmonary fibrosis]], [[Granuloma|pulmonary granuloma]], [[pulmonary hypertension]], [[Lymphoma|pulmonary lymphoma]], [[pulmonary metastases]], [[Pulmonary surfactant-associated protein B|pulmonary surfactant protein b, deficiency]], [[Pulmonary hypertension|pulmonary thromboembolic hypertension]], [[pulmonary tuberculosis]], [[pulmonic stenosis]], [[sarcoidosis]], [[Secondary pulmonary hypertension]], [[silicosis]], [[Pulmonary surfactant|surfactant metabolism dysfunction]].
|-
|-
|-bgcolor="LightSteelBlue"
|-bgcolor="LightSteelBlue"
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===Causes in Alphabetical Order===
===Causes in Alphabetical Order===
{{columns-list|3|
{{columns-list|


*[[Aneurysm]]  
*[[Aneurysm]]  
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*[[Arteriovenous malformations]]
*[[Arteriovenous malformations]]
*[[Arteriovenous shunts]]  
*[[Arteriovenous shunts]]  
*[[Asbestos]]
*[[Asbestosis]]  
*[[Asbestosis]]  
*[[Aspergillosis]]
*[[Aspergillosis]]
*[[Asthma|Asthma complicated by infection]]  
*[[Asthma|Asthma complicated by infection]]  
*[[Atrial myxoma]]  
*[[Atrial myxoma]]  
*[[Atrial septal defect (ostium primum)]]  
*[[Atrial septal defect]]  
*[[Berylliosis]]  
*[[Berylliosis]]  
*[[Biliary cirrhosis]]  
*[[Biliary cirrhosis]]  
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*[[Cystic fibrosis]]
*[[Cystic fibrosis]]
*[[Deafness ]]
*[[Deafness ]]
*[[Dexfenfluramine |Dexfenfluramine-associated]]
*[[Dexfenfluramine]]
*[[Situs inversus |Dextrocardia-bronchiectasis-sinusitis]]
*[[Situs inversus |Dextrocardia-bronchiectasis-sinusitis]]
*[[Diacetyl|Diacetyl inhalation]]
*[[Diacetyl|Diacetyl inhalation]]
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*[[Fenfluramine]]  
*[[Fenfluramine]]  
*[[Fibrosing alveolitis]]  
*[[Fibrosing alveolitis]]  
*[[Fibrosing alveolitis, cryptogenic]]
*[[Fischer syndrome]]  
*[[Fischer syndrome]]  
*[[Gastrointestinal cancer|Gastrointestinal neoplasms]]
*[[Gastrointestinal cancer|Gastrointestinal neoplasms]]
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*[[Hereditary haemorrhagic telangiectasia |Haemorrhagic telangiectasia]]
*[[Hereditary haemorrhagic telangiectasia |Haemorrhagic telangiectasia]]
*[[Hamman-Rich Syndrome ]]
*[[Hamman-Rich Syndrome ]]
*[[Heart failure]]
*[[Hepatoma]]
*[[Hepatoma]]
*[[Hepatopulmonary syndrome]]
*[[Hepatopulmonary syndrome]]
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*[[Inflammatory bowel disease]]
*[[Inflammatory bowel disease]]
*[[Interferon gamma]]
*[[Interferon gamma]]
*[[Interstitial lung disease|Interstitial lung disease]]
*[[Interstitial lung disease]]
*[[Interstitial pneumonitis]]
*[[Interstitial pneumonitis]]
*[[Interstitial lung disease |Interstitial pulmonary fibrosis]]
*[[Interstitial lung disease |Interstitial pulmonary fibrosis]]
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*[[Granuloma|Pulmonary granuloma]]  
*[[Granuloma|Pulmonary granuloma]]  
*[[Pulmonary hypertension]]  
*[[Pulmonary hypertension]]  
*[[Pulmonary hypertension |Pulmonary hypoxic hypertension]]
*[[Lymphoma |Pulmonary lymphoma]]  
*[[Lymphoma |Pulmonary lymphoma]]  
*[[Pulmonary metastases]]  
*[[Pulmonary metastases]]  

Latest revision as of 20:36, 10 January 2020

Clubbing Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Overview

Life threatening causes of clubbing include lung cancer, tetralogy of fallot, transposition of great vessels, and tricuspid atresia. Other common causes of clubbing are bronchiectasis, cystic fibrosis, cirrhosis, and empyema.

Causes

Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular Aneurysm, arterial vascular prosthesis infections, arteriovenous fistula, arteriovenous malformations, atrial myxoma, atrial septal defect, cerebrovascular insult, chronic hypoxia, common ventricle, congenital cardiovascular malformations, congestive heart failure, cyanotic congenital heart disease, conotruncal heart malformations, double outlet right ventricle, Eisenmenger syndrome, endocarditis, erythromelalgia , patent ductus arteriosus, pulmonary thromboembolic hypertension, right-to-left shunting, subacute bacterial endocarditis, Taussig-Bing syndrome, tetralogy of fallot, total anomalous pulmonary venous connection, transposition of the great vessels, tricuspid atresia, truncus arteriosus, pulmonic stenosis, heart cancer, ventricular septal defect.
Chemical / poisoning Ammonia inhalation, chlorine inhalation, diacetyl inhalation, hydrogen bromide inhalation, hydrogen chloride inhalation, hydrogen fluoride inhalation, hydrogen sulfide inhalation, methyl isocyanate inhalation, nitrogen oxide inhalation, Ozone inhalation, phosgene inhalation, polyamide-amine dyes inhalation, sulfur dioxide inhalation, thionyl chloride inhalation
Dermatologic Hereditary haemorrhagic telangiectasia, hidrotic ectodermal dysplasia, Shell nail syndrome
Drug Side Effect Cannabis, dexfenfluramine, fenfluramine, Interferon gamma, Senna
Ear Nose Throat Hereditary hemorrhagic telangiectasia, nasopharyngeal carcinoma
Endocrine Graves disease, Thyroid cancer, Thyrotoxicosis, POEMS syndrome
Environmental Mesothelioma, silicosis
Gastroenterologic Achalasia,celiac sprue, chronic liver disease, chronic obstructive jaundice, cirrhosis of liver, Crohn disease, cystic fibrosis, gastrointestinal neoplasms, hepatoma, hepatopulmonary syndrome, Inflammatory bowel disease, leiomyoma of the esophagus, liver tumors, malabsorption, oesophageal cancer, Peutz-Jeghers syndrome, primary biliary cirrhosis, small bowel lymphoma, stomach cancer, ulcerative colitis, Whipple disease
Genetic Celiac disease, crohn's disease, Cystic fibrosis, dextrocardia-bronchiectasis-sinusitis, Ebstein's anomaly, Eisenmenger syndrome, Peutz-Jeghers Syndrome, Taussig-Bing syndrome , hereditary haemorrhagic telangiectasia, Ivemark syndrome, Jansen's metaphyseal chondrodysplasia , pachydermoperiostosis
Hematologic Hodgkin lymphoma, Myelofibrosis
Iatrogenic No underlying causes
Infectious Disease Aspergillosis, empyema, Infective endocarditis, lymphadenitis, pulmonary abscess, pulmonary tuberculosis, subacute bacterial endocarditis, tuberculosis,
Musculoskeletal / Ortho Jansen's metaphyseal chondrodysplasia
Neurologic Cerebrovascular insult, hereditary hemorrhagic telangiectasia
Nutritional / Metabolic Celiac sprue, cystic fibrosis
Obstetric/Gynecologic No underlying causes
Oncologic Atrial myxoma, bronchial carcinoma, Hodgkin's disease, lung cancer, mesothelioma, metastatic melanoma, myelofibrosis , nasopharyngeal carcinoma, pancoast tumor, pleural fibroma, pleural mesothelioma,POEMS syndrome, Stomach cancer

thyroid cancer, thymus cancer

Opthalmologic No underlying causes
Overdose / Toxicity Cannabis
Psychiatric No underlying causes
Pulmonary Asbestosis, asthma complicated by infection, berylliosis,bronchial carcinoma,bronchiectasis, bronchiolitis obliterans, bronchogenic carcinoma, chronic hypoxia,chronic obstructive pulmonary disease ,cryptogenic fibrosing alveolitis,cystic fibrosis, emphysema,empyema,extrathoracic disease, extrinsic allergic alveolitis, familial interstitial fibrosis, familial pulmonary arterial hypertension, fibrosing alveolitis, Hamman-Rich Syndrome , hepatopulmonary syndrome, hypersensitivity pneumonitis,hypertrophic pulmonary osteoarthropathy, idiopathic diffuse interstitial fibrosis, idiopathic pulmonary fibrosis, idiopathic pulmonary haemosiderosis, idiopathic pulmonary hypertension , interstitial fibrosis, interstitial lung disease,interstitial pneumonitis, lipoid pneumonia,lung cancer, Marie-bamberg syndrome,pancoast tumor, pleural fibroma, pleural mesothelioma,polyarteritis nodosa,primary pulmonary hypertension, pulmonary abscess, pulmonary alveolar proteinosis, pulmonary arteriovenous malformation, pulmonary artery sarcoma,pulmonary artery sclerosis, pulmonary fibrosis, pulmonary granuloma, pulmonary hypertension, pulmonary lymphoma, pulmonary metastases, pulmonary surfactant protein b, deficiency, pulmonary thromboembolic hypertension, pulmonary tuberculosis, pulmonic stenosis, sarcoidosis, Secondary pulmonary hypertension, silicosis, surfactant metabolism dysfunction.
Renal / Electrolyte Polyarteritis nodosa
Rheum / Immune / Allergy Alpha heavy chain disease, celiac sprue, crohn's disease, Fischer syndrome, Graves disease, Kindler-weary bullous acrokeratotic poikiloderma, lymphoid interstitial pneumonia, polyarteritis nodosa, sarcoidosis.
Sexual No underlying causes
Trauma No underlying causes
Urologic No underlying causes
Miscellaneous Bindewald-ulmer-muller syndrome

Causes in Alphabetical Order

References

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