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  • Title: [Swelling of the knee, fatigue].
    Author: Billeter M, Streit E, Deuel W.
    Journal: Schweiz Rundsch Med Prax; 1991 Aug 20; 80(34):859-62. PubMed ID: 1925195.
    Abstract:
    A 43 year old man was admitted because of fatigue and swelling of the knees. Swelling of both knees, acropachy and turtle-back nails were registered during clinical investigation and laboratory tests showed leucocytosis, increased blood-sedimentation rate and alkaline phosphatase. Leucine aminopeptidase was normal. X-ray showed symmetric metaphyseal periosteal reactions on femora and tibiae of both sides compatible with hypertrophic osteoarthropathy. A parahilar round tumor measuring 5 x 7 cm infiltrating the right upper lobe was detected on chest x-ray suggestive of lung cancer. Pierre-Marie-Bamberger syndrome was diagnosed (hypertrophic osteoarthropathy associated with cancer of the lung). Under radiotherapy to the tumor the osteoarthropathy subsided and alkaline phosphatase returned to normal.
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