Plummer's Nails (Onycholysis) in a Thyroid-stimulation-blocking Antibody (TSBAb)-positive Patient with Hypothyroidism

doi:10.2169/internalmedicine.0809-18

Paper

Plummer's Nails (Onycholysis) in a Thyroid-stimulation-blocking Antibody (TSBAb)-positive Patient with Hypothyroidism

Published May 18, 2018 · N. Takasu, Hiromichi Seki

Internal Medicine

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Abstract

A 46-year old woman presented with symptoms and signs of hypothyroidism, including bradycardia and delayed reflexes. She had fingernail changes that were consistent with onycholysis (Plummer’s nails) (Picture). She had thyroidstimulation-blocking antibody (TSBAb)-positive hypothyroidism (TSBAb 87%, serum thyroid-stimulating hormone (TSH) 76 mIU/L). The patient’s fingernails had the characteristic appearance of Plummer’s nails, a condition first described by Plummer in a patient with hyperthyroidism (1). Onycholysis, a condition in which the distal nail body separates from the nail bed, commonly occurs on the fourth fingers (Picture). Onycholysis has been said to be seen in patients with Graves’ hyperthyroidism. However, onycholysis is not specific to thyrotoxicosis. The differential diagnoses

Case Report

Study Snapshot

Plummer's nails in a patient with TSBAb-positive hypothyroidism suggest that onycholysis may not be specific to thyrotoxicosis, and should be considered in patients with TSBAb-positive hypothyroidism.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

Plummer's Nails (Onycholysis) in a Thyroid-stimulation-blocking Antibody (TSBAb)-positive Patient with Hypothyroidism

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