Focal Digital Clubbing as an Initial Symptom of Adolescent-Onset Systemic Lupus Erythematosus: A Case Report

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Abstract
Digital clubbing is typically linked to pulmonary or cardiovascular diseases. There have been no reported cases of systemic lupus erythematosus (SLE) where the initial complaint was solely foca digital clubbing and a chilblain-like rash on the ngers. A 13-year-old girl experienced digital clubbing for 3 months. Physical examination revealed focal digital clubbing of the thumb, index nger, and middle nger on her right hand, along with slight blotchy erythema assessed as a chilblain-like rash. Laboratory data showed hypocomplementemia and a high anti-double-stranded DNA antibody titer. She was also positive for antiphospholipid antibodies, had prolonged prothrombin time and activated partial thromboplastin time, and elevated anti-prothrombin antibody levels. She was diagnosed with SLE complicated by hypoprothrombinemia associated with lupus anticoagulant. Prednisolone treat ment resolved the digital clubbing and laboratory abnormalities. Digital clubbing may be an initial symptom of SLE. Screening for autoimmune diseases should be considered when a patient presents with digital clubbing not associated with pulmonary or cardiovascular diseases or malignant tumors. Cite this article as: Sato M, Nagamori T, Kurisawa MJ, Tsuda J, Ishibazawa E, Takahashi S. Focal digital clubbing as an initial symptom of adolescent-onset systemic lupus erythematosus: a case report. Eur J Rheumatol. 2025, 12(4), 0075, doi:10.5152/eurjrheum.2025.24075.

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