I have a 52 y/o patient who is an African American male inmate, his finger nails are inferiorly "bent", Dx=?

He has Hx lost 35lb in less than 6mos. All CXR, chx and abd. CT, CBC, and other tests are normal. Pt denied cough, fever, chill, sweat, nausea and vomiting....ect. On PE, His finger nails are inferiorly (anatomy: anteriorly) bent such as "eagle beak" and continued to curve upward (anatomy: superiorly). The nail bads appeared to be "clubbing" as well. I could not find any answer or the Dx for the bent finger nails, mechanisms, pathophysiology, etc. Any hidden malignancy/CNS? Please help. Thank you very much.

Tough to say from a distance. Have you done an autoimmune panel? ESR? HIV test? There have been cases in the past of clubbing seen with HIV infection with minimal other Sx.

Keep in mind that if the two (weight loss & clubbing) are related, and I would assume so until proven otherwise, then the patient may deny some Sx if the disease has an insidious course.

well , the clubbing of the fingers can be due to a heart defect ,usually a cyanotic defect, and the weight loss, he was in jail, could it be that the patient is HIV positive and no one knows? Pulmonary Hypertension, maybe....

He could have sickle cell trait that only appears when stressed. Also check for fungal infections of the beds

It could be anemia or a lung disease(emphysema, COPD, pulmonary fibrosis...)

Good luck

well id be guessing the the weight loss and clubbing are unrelated in cause, but i suppose there are forms of iron deficiency anemia that lead to nail deformities (like in plummer vinnson) that may also account for weight loss but not the clubbing. both crohns disease and ulcerative colitis can cause anemia and clubbing, assuming hes anemic but if the labwork didnt show it then again i would think there unrelated.