Abstract
•We report on a case of multiple bilateral trigger fingers in a child with NF I.•Triggering developed while the child was on chemotherapy following an acute viral infection.•The pathogenesis is discussed.
Triggering of the fingers in children is an uncommon entity. A review of the literature on the topic did not reveal any reports of multiple triggering in patients with neurofibromatosis.
Our patient is a known case of neurofibromatosis type I (NF 1). At the age of 4 years, the child required chemotherapy to treat symptomatic bilateral optic glioma. Chemotherapy was complicated by severe viral upper respiratory tract infection with concurrent multi-joint synovitis and mild triggering of the fingers. A second course of chemotherapy was required 2 years later. This was also complicated by a viral infection, joint synovitis, and worsening of the triggering. Surgical release of the A1 and part of the A2 pulleys was curative.
Two factors contributed to the development of multiple triggering in our pediatric patient. The NF 1 itself predisposes to fibrosis. The second factor is the synovitis that accompanied the acute viral infection.
We report on a case of multiple bilateral trigger fingers in a child with NF 1 following an acute viral infection and discuss the pathogenesis.