my hypothesis on the mechanism behind the clubbing of fingers

[entropy]

I've asked a few doctors why people with CF get clubbed fingers, and they could never give me a good answer. They would say "we don't really know", etc.

I have come up with my own hypothesis, which I think makes sense.

Decreased lung function, as the result of CF, would create a situation where blood O2 levels are lower in the night time than during the day when a person is able to consciously able to control their breathing. It's understood that people with CF often suffer from low O2 stats during sleep. In times of low oxygen saturation, the fingertips and toes would receive the least amount of oxygen. Long term cycles of hypoxic damage to the fingertips during the night and subsequent cell repair during the day would create a constant state of inflammation, which over time would get worse as the cycle of the fingertips being damaged at night isn't expected to stop. So, essentially, once a person reaches the point in the progression of their CF that they suffer from low O2 levels during sleep, they will begin to notice clubbing of the fingers shortly thereafter.

This is my humble hypothesis. Any thoughts?

 

[entropy]

I've asked a few doctors why people with CF get clubbed fingers, and they could never give me a good answer. They would say "we don't really know", etc.

I have come up with my own hypothesis, which I think makes sense.

Decreased lung function, as the result of CF, would create a situation where blood O2 levels are lower in the night time than during the day when a person is able to consciously able to control their breathing. It's understood that people with CF often suffer from low O2 stats during sleep. In times of low oxygen saturation, the fingertips and toes would receive the least amount of oxygen. Long term cycles of hypoxic damage to the fingertips during the night and subsequent cell repair during the day would create a constant state of inflammation, which over time would get worse as the cycle of the fingertips being damaged at night isn't expected to stop. So, essentially, once a person reaches the point in the progression of their CF that they suffer from low O2 levels during sleep, they will begin to notice clubbing of the fingers shortly thereafter.

This is my humble hypothesis. Any thoughts?

 

[entropy]

I've asked a few doctors why people with CF get clubbed fingers, and they could never give me a good answer. They would say "we don't really know", etc.
<br />
<br />I have come up with my own hypothesis, which I think makes sense.
<br />
<br />Decreased lung function, as the result of CF, would create a situation where blood O2 levels are lower in the night time than during the day when a person is able to consciously able to control their breathing. It's understood that people with CF often suffer from low O2 stats during sleep. In times of low oxygen saturation, the fingertips and toes would receive the least amount of oxygen. Long term cycles of hypoxic damage to the fingertips during the night and subsequent cell repair during the day would create a constant state of inflammation, which over time would get worse as the cycle of the fingertips being damaged at night isn't expected to stop. So, essentially, once a person reaches the point in the progression of their CF that they suffer from low O2 levels during sleep, they will begin to notice clubbing of the fingers shortly thereafter.
<br />
<br />This is my humble hypothesis. Any thoughts?

 

[kitomd21]

Well...I would tend to disagree that this is the case for all individuals with CF. DD was born with some degree of clubbing. Her doctor maintains that there isn't a linear relationship between clubbing and lung function. Some individuals who are PI exhibit clubbing, some people with decreased lung function show clubbing...

 

[kitomd21]

Well...I would tend to disagree that this is the case for all individuals with CF. DD was born with some degree of clubbing. Her doctor maintains that there isn't a linear relationship between clubbing and lung function. Some individuals who are PI exhibit clubbing, some people with decreased lung function show clubbing...

 

[kitomd21]

Well...I would tend to disagree that this is the case for all individuals with CF. DD was born with some degree of clubbing. Her doctor maintains that there isn't a linear relationship between clubbing and lung function. Some individuals who are PI exhibit clubbing, some people with decreased lung function show clubbing...

 

[AimeeSue82]

My fingers and toes have a lot of clubbing and have since I was a kid, when my lungs were great. Since my lung function has dropped, they haven't gotten worse though. Perhaps it has something to do with the salt or the mutation. On a side note, if anyone ever figures out how to make it reverse, let me know!!! I hate my fingers, I won't let my hands be in pictures because that's all I see.

~Aimee, 28 w/ CF (PA & MRSA)

 

[AimeeSue82]

My fingers and toes have a lot of clubbing and have since I was a kid, when my lungs were great. Since my lung function has dropped, they haven't gotten worse though. Perhaps it has something to do with the salt or the mutation. On a side note, if anyone ever figures out how to make it reverse, let me know!!! I hate my fingers, I won't let my hands be in pictures because that's all I see.

~Aimee, 28 w/ CF (PA & MRSA)

 

[AimeeSue82]

My fingers and toes have a lot of clubbing and have since I was a kid, when my lungs were great. Since my lung function has dropped, they haven't gotten worse though. Perhaps it has something to do with the salt or the mutation. On a side note, if anyone ever figures out how to make it reverse, let me know!!! I hate my fingers, I won't let my hands be in pictures because that's all I see.
<br />
<br />~Aimee, 28 w/ CF (PA & MRSA)

 

[LouLou]

I believe people with Liver disease (not CF kind necessarily) often have clubbing. They don't suffer from low O2. I believe it's one of those unanswered questions.

 

[LouLou]

I believe people with Liver disease (not CF kind necessarily) often have clubbing. They don't suffer from low O2. I believe it's one of those unanswered questions.

 

[LouLou]

I believe people with Liver disease (not CF kind necessarily) often have clubbing. They don't suffer from low O2. I believe it's one of those unanswered questions.

 

[ej0820]

It makes perfect sense that lung function and the clubbing are related, though I don't quite know how. Mutation alone also makes sense as I, too, have ALWAYS had clubbed fingers (not toes so much), even as a child when my lung function was nearly perfect for my age and weight/height. I didn't start getting bad lung-wise until my late teens (I was first hospitalized when I was 18) and again, my fingers were already clubbed by then, despite growing up with an FEV >100.

My lung function is now <40 and I don't really know that my fingers are any more clubbed than they ever have been. I could say that my toes are, though I don't know that I ever paid much attention to their degree of clubbing, so for all I know, they aren't any different either...

I was once told that those that have had lung txs have had their clubbing lessen or even disappear. The mystery remains unsolved with my reply here, lol.

Good inquiry, though!

 

[ej0820]

It makes perfect sense that lung function and the clubbing are related, though I don't quite know how. Mutation alone also makes sense as I, too, have ALWAYS had clubbed fingers (not toes so much), even as a child when my lung function was nearly perfect for my age and weight/height. I didn't start getting bad lung-wise until my late teens (I was first hospitalized when I was 18) and again, my fingers were already clubbed by then, despite growing up with an FEV >100.

My lung function is now <40 and I don't really know that my fingers are any more clubbed than they ever have been. I could say that my toes are, though I don't know that I ever paid much attention to their degree of clubbing, so for all I know, they aren't any different either...

I was once told that those that have had lung txs have had their clubbing lessen or even disappear. The mystery remains unsolved with my reply here, lol.

Good inquiry, though!

 

[ej0820]

It makes perfect sense that lung function and the clubbing are related, though I don't quite know how. Mutation alone also makes sense as I, too, have ALWAYS had clubbed fingers (not toes so much), even as a child when my lung function was nearly perfect for my age and weight/height. I didn't start getting bad lung-wise until my late teens (I was first hospitalized when I was 18) and again, my fingers were already clubbed by then, despite growing up with an FEV >100.
<br />
<br />My lung function is now <40 and I don't really know that my fingers are any more clubbed than they ever have been. I could say that my toes are, though I don't know that I ever paid much attention to their degree of clubbing, so for all I know, they aren't any different either...
<br />
<br />I was once told that those that have had lung txs have had their clubbing lessen or even disappear. The mystery remains unsolved with my reply here, lol.
<br />
<br />Good inquiry, though!

 

[Lex]

I had HIGH expectations that after receiving a TX my fingers and toes would return to normal. Well, no such luck. My lung function is thru the roof and my fingers and toes haven't improved at all. Though, at my worst, my nails had "ridges" and after my TX, I could literally watch the "ridge line" slowly grow out until my nails were smooth again.

On a side note, my grandfather had clubbing and no CF. He was a chain smoker, but if it was truly a lung function result, why hasn't my TX helped at all? I was/am bummed out about that. But I'm not complaining. I'll take my FEV1 today and clubbing over no clubbing and my stupid CF lungs. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[Lex]

I had HIGH expectations that after receiving a TX my fingers and toes would return to normal. Well, no such luck. My lung function is thru the roof and my fingers and toes haven't improved at all. Though, at my worst, my nails had "ridges" and after my TX, I could literally watch the "ridge line" slowly grow out until my nails were smooth again.

On a side note, my grandfather had clubbing and no CF. He was a chain smoker, but if it was truly a lung function result, why hasn't my TX helped at all? I was/am bummed out about that. But I'm not complaining. I'll take my FEV1 today and clubbing over no clubbing and my stupid CF lungs. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[Lex]

I had HIGH expectations that after receiving a TX my fingers and toes would return to normal. Well, no such luck. My lung function is thru the roof and my fingers and toes haven't improved at all. Though, at my worst, my nails had "ridges" and after my TX, I could literally watch the "ridge line" slowly grow out until my nails were smooth again.
<br />
<br />On a side note, my grandfather had clubbing and no CF. He was a chain smoker, but if it was truly a lung function result, why hasn't my TX helped at all? I was/am bummed out about that. But I'm not complaining. I'll take my FEV1 today and clubbing over no clubbing and my stupid CF lungs. <img src="i/expressions/face-icon-small-smile.gif" border="0">

 

[Landy]

I see your point & even Dr's sometimes think clubbing is tied to lung function, but I disagree. I had very good lung function until my late 20s, but always had clubbing.

I was watching <i>Dr G Medical Examiner </i>one night & one of her cases had finger clubbing and she tied the clubbing to digestive issues and I had severe digestion issues as an infant/toddler, so that theory may be correct?
It could be tied to mutations, as someone else mentioned.

 

[Landy]

I see your point & even Dr's sometimes think clubbing is tied to lung function, but I disagree. I had very good lung function until my late 20s, but always had clubbing.

I was watching <i>Dr G Medical Examiner </i>one night & one of her cases had finger clubbing and she tied the clubbing to digestive issues and I had severe digestion issues as an infant/toddler, so that theory may be correct?
It could be tied to mutations, as someone else mentioned.