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A 36-year-old man was referred for further evaluation after having changes in his fingers that were initially thought to be due to clubbing (Panels A and B). He had a history of obstructive nephropathy necessitating hemodialysis and renal transplantation. His course had been complicated by severe secondary hyperparathyroidism requiring parathyroidectomy. The digital changes had first been noted several years earlier, while he was undergoing dialysis, and progressed until he underwent parathyroidectomy. Close examination revealed that the nail-fold angle, or Lovibond's angle, was well preserved, and a diagnosis of pseudoclubbing from previous hyperparathyroidism was made. The changes in this patient's fingers . . . [Full Text of this Article] |
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