Acropachy

A detailed overview of acropachy, a condition associated with thyroid disease

Acropachy

Diagram illustrating autosomal recessive inheritance, which is not directly related to acropachy but useful for understanding genetic conditions.

Acropachy is a rare condition characterized by soft-tissue swelling of the hands and clubbing of the fingers. It is most commonly associated with Graves' disease, an autoimmune disorder that affects the thyroid gland. Acropachy is considered a form of thyroid dermopathy, which also includes pretibial myxedema.

Pathophysiology

Acropachy is believed to result from the same autoimmune processes that cause Graves' disease. The exact mechanism is not fully understood, but it involves the deposition of glycosaminoglycans in the soft tissues, leading to swelling and clubbing. The condition is often seen in conjunction with other manifestations of Graves' disease, such as ophthalmopathy and hyperthyroidism.

Clinical Features

Patients with acropachy typically present with:

• Swelling of the fingers and toes
• Clubbing of the digits
• Periosteal new bone formation

These symptoms can be confirmed through clinical examination and imaging studies, such as X-rays, which may show periosteal reaction.

Diagnosis

The diagnosis of acropachy is primarily clinical, based on the characteristic appearance of the hands and feet. It is important to differentiate it from other causes of clubbing, such as pulmonary disease or congenital heart disease.

Management

There is no specific treatment for acropachy. Management focuses on controlling the underlying Graves' disease, which may involve:

• Antithyroid drugs
• Radioactive iodine therapy
• Thyroidectomy

Symptomatic treatment for acropachy may include nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and swelling.

Prognosis

The prognosis of acropachy is generally good, especially if the underlying thyroid disease is well-managed. However, the condition can be persistent and may not completely resolve even with treatment.

Related pages

• Graves' disease
• Thyroid dermopathy
• Ophthalmopathy
• Hyperthyroidism