[Hippocratic fingers and hypertrophic osteoarthropathy. Their interrelation and probable physiopathogenic mechanisms].

Based in our own clinical studies, we state our point of view, regarding two controversial issues in the literature: 1) the relationship between digital clubbing and hypertrophic osteoartropathy (HOA), and 2) its pathogenic mechanisms. We agree with the theory which proposes that clubbing is the initial, and most conspicuous sing of a full syndrome, (HOA). These entities develop when the lung fails to inactivate a vasodilator and bone-remodeling substance normally present in the systemic venous circulation. This failure of the lung could be due to exclusion, as is the case in the right-to-left shunts, or because of functional deterioration that develops in conditions such as in lung cancer or cystic fibrosis.