下剤で撥状指/よく抜けた（毛ではありません）
Digital clubbing has been regarded as an important sign in medicine. A 33-year-old woman with no history of hepatic, pulmonary, or malignant disease was referred to our hospital. She had been taking lubiprostone every day for three years for constipation. Clubbing in her upper and lower limb digits began gradually about two years ago. The results of laboratory investigations were almost normal. We suspected the clubbed digits were a side effect of lubiprostone and confirmed that the levels of urinary prostaglandin E2 (PGE2), which can cause clubbed digits, were elevated. Thus, we instructed the woman to stop taking lubiprostone and monitored this lab value. However, the value continued to rise over 2 months to 41.9 μg/g Cr. During that time, she had been taking sennoside A B calcium instead of lubiprostone for constipation. Since sennoside A B calcium also has the effect of increasing PGE2, we ordered the discontinuation. Her urinary PGE2 to creatinine level normalized, and the clubbing improved after the discontinuation of these two medications.
・↑に出てくるLubiprostoneとは商品名アミティーザで、比較的最近発売された下剤ですね。添付文書は↓
アミティーザカプセル
https://www.info.pmda.go.jp/go/pack/2359006M1025_2_05/
・私が驚いたのは、ルビプロストンというよりは、センノシドでバチ状指が起こるということです。
以下一瞬日記
・本日8/9(月)は、ルーチンの仕事（燃えるごみ出したり猫にえさやったり）後は、食事以外は適宜休憩をはさんで勉強、講義準備、発表準備等でした。夕方は２時間ばかり草抜き。雨上がりよう抜けます。髪の毛で抜けるのは困りますが、雑草（昭和天皇に怒られるが↓）はよく抜けると気持ちよい。その後お風呂入って夕食。缶ビール１本だけいただきました。今日は２１時までにビールが届くはずだったのにまだ来ません。台風の影響で配送が遅延しているみたいです。もう寝ようと思うのにどうしましょ。業者さんの立場に立てば、大変でしょうね。
