Clubbing causes

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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

• Aneurysm
• Lung cancer
• Tetralogy of Fallot
• Transposition of the great vessels
• Tricuspid atresia
• Truncus arteriosus

Common Causes

• Bronchiectasis
• Cystic fibrosis
• Celiac disease
• Cirrhosis
• Empyema
• Graves disease
• Lung abscess

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

• Aneurysm
• Erythromelalgia
• Achalasia
• Alpha heavy chain disease
• Ammonia inhalation
• Arterial vascular prosthesis infections
• Arteriovenous fistula
• Arteriovenous malformations
• Arteriovenous shunts
• Asbestosis
• Aspergillosis
• Asthma complicated by infection
• Atrial myxoma
• Atrial septal defect
• Berylliosis
• Biliary cirrhosis
• Bindewald-ulmer-muller syndrome
• Bronchial carcinoma
• Bronchiectasis
• Bronchiolitis obliterans
• Bronchogenic carcinoma
• Cannabis
• Cardiac tumor
• Celiac sprue
• Cerebrovascular insult
• Chlorine inhalation
• Chronic hypoxia
• Chronic liver disease
• Chronic obstructive jaundice
• Chronic obstructive pulmonary disease
• Cirrhosis
• Celiac disease
• Common ventricle
• Complicated tuberculosis
• Congenital
• Congenital arteriovenous shunt
• Congenital cardiovascular malformations
• Congenital heart defects
• Congenital cyanotic heart disease
• Congestive heart failure
• Conotruncal heart malformations
• Cranio osteoarthropathy
• Crohn's disease
• Cryptogenic fibrosing alveolitis
• Cystic fibrosis
• Deafness
• Dexfenfluramine
• Dextrocardia-bronchiectasis-sinusitis
• Diacetyl inhalation
• Double outlet right ventricle
• Ebstein's anomaly
• Eisenmenger syndrome
• Emphysema
• Endocarditis
• Esophageal achalasia
• Extrathoracic disease
• Extrinsic allergic alveolitis
• Fallot syndrome
• Familial interstitial fibrosis
• Familial pulmonary arterial hypertension
• Fenfluramine
• Fibrosing alveolitis
• Fischer syndrome
• Gastrointestinal neoplasms
• Graves disease
• Haemorrhagic telangiectasia
• Hamman-Rich Syndrome
• Hepatoma
• Hepatopulmonary syndrome
• Hereditary haemorrhagic telangiectasia
• Hidrotic ectodermal dysplasia
• Hodgkin lymphoma
• Hydrogen bromide inhalation
• Hydrogen chloride inhalation
• Hydrogen fluoride inhalation
• Hydrogen sulfide inhalation
• Hypersensitivity pneumonitis
• Hypertrophic pulmonary osteoarthropathy
• Idiopathic diffuse interstitial fibrosis
• Idiopathic pulmonary fibrosis
• Idiopathic pulmonary haemosiderosis
• Idiopathic pulmonary hypertension
• Infective endocarditis
• Inflammatory bowel disease
• Interferon gamma
• Interstitial lung disease
• Interstitial pneumonitis
• Interstitial pulmonary fibrosis
• Ivemark syndrome
• Jansen's metaphyseal chondrodysplasia
• Kindler-weary bullous acrokeratotic poikiloderma
• Liver tumors
• Lung abscess
• Lung cancer
• Lymphadenitis
• Lymphoid interstitial pneumonia
• Malabsorption
• Marie-bamberg syndrome
• Mesothelioma
• Mesothelioma of the pleura
• Metastatic melanoma
• Methyl isocyanate inhalation
• Mycobacterium tuberculosis
• Myelofibrosis
• Myxomas
• Nasopharyngeal carcinoma
• Nitrogen oxide inhalation
• Oesophageal cancer
• Overactive thyroid gland
• Ozone inhalation
• Pachydermoperiostosis
• Pancoast tumor
• Patent ductus arteriosus
• Peripheral shunt
• Peutz-Jeghers syndrome
• Phosgene inhalation
• Pleural fibroma
• POEMS syndrome
• Polyamide-amine dyes inhalation
• Polyarteritis nodosa
• Primary biliary cirrhosis
• Primary pulmonary hypertension
• Pulmonary alveolar proteinosis
• Pulmonary arterio-veinous aneurysm
• 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
• Right-to-left cardiac shunts
• Sarcoidosis
• Secondary pulmonary hypertension
• Senna
• Shell nail syndrome
• Silicosis
• Small bowel lymphoma
• Sprue
• Stomach cancer
• Subacute bacterial endocarditis
• Sulphur dioxide inhalation
• Surfactant metabolism dysfunction
• Taussig-Bing syndrome
• Tetralogy of fallot
• Thionyl chloride inhalation
• Thyroid cancer
• Thyrotoxicosis
• Total anomalous venous connection
• Transposition of the great vessels
• Tricuspid atresia
• Truncus arteriosus
• Tuberculosis
• Ulcerative colitis
• Vascular anomalies
• Ventricular septal defect
• Whipple disease