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{{Short description|Any of various diseases that seem similar to others in their signs and symptoms}}
{{Short description|Disease that shows symptoms of another}}
'''The Great Imitator''' (also '''the Great Masquerader''') is a phrase used for [[medical condition]]s that feature [[nonspecific symptoms]] and may be confused with a number of other diseases.<ref name="Segen1992">J.C. Segen. ''[https://books.google.com/books?id=FbSlyyshjOoC&pg=PA265 The Dictionary of Modern Medicine]''. CRC Press; 1992. {{ISBN|978-1-85070-321-1}}. p. 265.</ref> The term [[connotation|connotes]] especially difficult [[differential diagnosis]] (DDx), especial potential for [[misdiagnosis]], and the [[wikt:protean#Adjective|protean]] nature of some diseases. Most great imitators are [[systemic disease|systemic]] in nature or have systemic [[sequela]]e, and an aspect of [[nonspecific symptom]]s is logically almost always involved. In some cases, an assumption that a particular sign or symptom, or a particular pattern of several thereof, is [[pathognomonic]] turns out to be false, as the reality is that it is only nearly so.
'''The Great Imitator''' (also '''the Great Masquerader''') is a phrase used for [[medical condition]]s that feature [[nonspecific symptoms]] and may be confused with a number of other diseases.<ref name="Segen1992">J.C. Segen. ''[https://books.google.com/books?id=FbSlyyshjOoC&pg=PA265 The Dictionary of Modern Medicine]''. CRC Press; 1992. {{ISBN|978-1-85070-321-1}}. p. 265.</ref> The term [[connotation|connotes]] especially difficult [[differential diagnosis]] (DDx), increased potential for [[misdiagnosis]], and the [[wikt:protean#Adjective|protean]] nature of some diseases. Most great imitators are [[systemic disease|systemic]] in nature or have systemic [[sequela]]e, and an aspect of [[nonspecific symptom]]s is logically almost always involved. In some cases, an assumption that a particular sign or symptom, or a particular pattern of several thereof, is [[pathognomonic]] turns out to be false, as the reality is that it is only nearly so.


As recently as the 1950s, [[syphilis]] was widely considered by physicians to be "the great imitator", and in the next few decades after that, several other candidates, mainly [[tuberculosis]]<ref name="JAMA-1961-TB"/> but occasionally others,<ref name="pmid-7004168">{{cite journal |last1=Froede |first1=RC |last2=Gordon |first2=JD |title=Alcoholism--the second great imitator. An introduction to the problem of alcoholism. |journal=American journal of clinical pathology |date=November 1980 |volume=74 |issue=5 |pages=719-20 |doi=10.1093/ajcp/74.5.719 |pmid=7004168}}</ref> were asserted as being "the second great imitator". But because [[differential diagnosis]] is inherently subject to occasional difficulty and to [[false positives and false negatives]], the idea that there are only one or two great imitators was more melodrama than objective description. In recent decades, more than a dozen diseases have been recognized in the medical literature as worthy of being considered great imitators, on the common theme of recurring misdiagnoses/missed diagnoses and protean manifestations. Nonetheless, not every DDx caveat (not every mimic) meets the threshold, because it is inherent to DDx generally that there are thousands of caveats (thousands of instances of the theme, "be careful to rule out X before diagnosing Y"); for example, ectopic pregnancy and ovarian neoplasia can mimic each other, as can myocardial infarction and panic attack, but they are not established as great imitators per se (rather, merely DDx considerations). The list of great imitators here relies on references in the medical literature applying that label, or on other references documenting a condition's especially ''recurrent'' and poignant reputation for misdiagnoses.
As recently as the 1950s, [[syphilis]] was widely considered by physicians to be "the great imitator", and in the next few decades after that, several other candidates, mainly [[tuberculosis]]<ref name="JAMA-1961-TB"/> but occasionally others,<ref name="pmid-7004168">{{cite journal |last1=Froede |first1=RC |last2=Gordon |first2=JD |title=Alcoholism--the second great imitator. An introduction to the problem of alcoholism. |journal=American Journal of Clinical Pathology |date=November 1980 |volume=74 |issue=5 |pages=719–20 |doi=10.1093/ajcp/74.5.719 |pmid=7004168}}</ref> were asserted as being "the second great imitator". But because [[differential diagnosis]] is inherently subject to occasional difficulty and to [[false positives and false negatives]], the idea that there are only one or two great imitators was more melodrama than objective description. In recent decades, more than a dozen diseases have been recognized in the medical literature as worthy of being considered great imitators, on the common theme of recurring misdiagnoses/missed diagnoses and protean manifestations. Nonetheless, not every DDx caveat (not every mimic) meets the threshold, because it is inherent to DDx generally that there are thousands of caveats (thousands of instances of the theme, "be careful to rule out X before diagnosing Y"); for example, ectopic pregnancy and ovarian neoplasia can mimic each other, as can myocardial infarction and panic attack, but they are not established as great imitators per se (rather, merely DDx considerations). The list of great imitators here relies on references in the medical literature applying that label, or on other references documenting a condition's especially ''recurrent'' and poignant reputation for misdiagnoses.


Conditions or diseases sometimes referred to with this nickname thus include the following:
Conditions or diseases sometimes referred to with this nickname thus include the following:


==Low blood sugar==
==Low blood sugar==
* [[Hypoglycemia]] as [[#Thromboembolic events or their mimics|an imitator of a stroke]]<ref name="pmid-28932374">{{cite journal |last1=Hosseininezhad |first1=M |last2=Sohrabnejad |first2=R |title=Stroke mimics in patients with clinical signs of stroke. |journal=Caspian journal of internal medicine |date=2017 |volume=8 |issue=3 |pages=213-216 |doi=10.22088/cjim.8.3.213 |pmid=28932374}}</ref>
* [[Hypoglycemia]] as [[#Thromboembolic events or their mimics|an imitator of a stroke]]<ref name="pmid-28932374">{{cite journal |last1=Hosseininezhad |first1=M |last2=Sohrabnejad |first2=R |title=Stroke mimics in patients with clinical signs of stroke. |journal=Caspian Journal of Internal Medicine |date=2017 |volume=8 |issue=3 |pages=213–216 |doi=10.22088/cjim.8.3.213 |pmid=28932374|pmc=5596193 }}</ref>


==Tumors (neoplasms), especially cancerous tumors or any endocrine tumors==
==Tumors (neoplasms), especially cancerous tumors or any endocrine tumors==
{{anchor|Tumors}}
* [[Cancer]]s generally<ref name=Card10>{{cite book |first=Donald W. |last=Kufe |title=Holland-Frei cancer medicine |year=2009 |publisher=McGraw-Hill Medical |location=New York |isbn=978-1-60795-014-1 |pages=1–3 |url=https://books.google.com/books?id=R0FbhLsWHBEC&pg=PA1 |edition=8th}}</ref>
* [[Cancer]]s generally<ref name=Card10>{{cite book |first=Donald W. |last=Kufe |title=Holland-Frei cancer medicine |year=2009 |publisher=McGraw-Hill Medical |location=New York |isbn=978-1-60795-014-1 |pages=1–3 |url=https://books.google.com/books?id=R0FbhLsWHBEC&pg=PA1 |edition=8th}}</ref>
** [[Intravascular large B-cell lymphoma]]<ref>{{cite journal|first=Joseph |last=Del Paggio |display-authors=etal |title=Disturbances in blood flow and 'medicine's greatest imitator'|journal=Internal Medicine Journal|volume=47|issue=5|pages=586–588|year=2017|doi=10.1111/imj.13414|pmid=28503874|s2cid=3799976 }}</ref>
** [[Intravascular large B-cell lymphoma]]<ref>{{cite journal|first=Joseph |last=Del Paggio |display-authors=etal |title=Disturbances in blood flow and 'medicine's greatest imitator'|journal=Internal Medicine Journal|volume=47|issue=5|pages=586–588|year=2017|doi=10.1111/imj.13414|pmid=28503874|s2cid=3799976 }}</ref>
** [[Mycosis fungoides]]<ref name="pmid-31178107">{{cite journal |last1=Hodak |first1=E |last2=Amitay-Laish |first2=I |title=Mycosis fungoides: a great imitator. |journal=Clinics in dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=255-267 |doi=10.1016/j.clindermatol.2019.01.004 |pmid=31178107}}</ref>
** [[Mycosis fungoides]]<ref name="pmid-31178107">{{cite journal |last1=Hodak |first1=E |last2=Amitay-Laish |first2=I |title=Mycosis fungoides: a great imitator. |journal=Clinics in Dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=255–267 |doi=10.1016/j.clindermatol.2019.01.004 |pmid=31178107|s2cid=81927761 }}</ref>
** [[Metastasis|Malignant metastases]]
** [[Metastasis|Malignant metastases]]
*** Cutaneous metastases<ref name="pmid-32513401">{{cite journal |last1=Jaros |first1=J |last2=Hunt |first2=S |last3=Mose |first3=E |last4=Lai |first4=O |last5=Tsoukas |first5=M |title=Cutaneous metastases: a great imitator. |journal=Clinics in dermatology |date=2020-03-01 |volume=38 |issue=2 |pages=216-222 |doi=10.1016/j.clindermatol.2019.10.004 |pmid=32513401}}</ref>
*** Cutaneous metastases<ref name="pmid-32513401">{{cite journal |last1=Jaros |first1=J |last2=Hunt |first2=S |last3=Mose |first3=E |last4=Lai |first4=O |last5=Tsoukas |first5=M |title=Cutaneous metastases: a great imitator. |journal=Clinics in Dermatology |date=2020-03-01 |volume=38 |issue=2 |pages=216–222 |doi=10.1016/j.clindermatol.2019.10.004 |pmid=32513401|s2cid=208446382 }}</ref>
* [[Oral cancer]]<ref>{{Cite book |last1=Kellerman |first1=Rick D. |url=https://books.google.com/books?id=rsJ9DwAAQBAJ&dq=%22called+the+great+imitator%22+-tuberculosis+-syphilis&pg=PT1007 |title=Conn's Current Therapy 2019 |last2=Rakel |first2=David |date=2018-12-06 |publisher=Elsevier Health Sciences |isbn=978-0-323-59650-3 |pages=971 |language=en |quote=Oral cancer has been called the great imitator, for it can appear as many different oral conditions.}}</ref>
* [[Pheochromocytoma]]
* [[Pheochromocytoma]]
* [[Paraneoplastic syndrome]]s, in [[endocrine oncology]]: symptoms from any type of functioning (that is, [[hormone]]-producing) endocrine tumor; such tumors secrete excess hormones in a way that is homeostatically senseless, thus disrupting [[homeostasis]] (in any of many diverse ways, depending on which hormone, what dosage, and which location)
* [[Paraneoplastic syndrome]]s
** Functioning [[neuroendocrine tumor]]s (NETs)<!--which the cited ref of 2022-12-17 says are known to be not only zebras but also great imitators-->
*** Most generally, a caveat to obtain [[PET-CT]] in cases where [[differential diagnosis]] seems to be repeatedly failing, as PET can "see" NETs better than other imaging can<ref name="Boodman-2022-12-17"/>
*** Functioning [[pancreatic neuroendocrine tumor]]s (panNETs or pNETs) (example: intractable [[diarrhea]] resistant to differential diagnosis<ref name="Boodman-2022-12-17">{{cite news |last1=Boodman |first1=Sandra G. |title=Her crippling digestive problems were caused by a 'zebra' malady [pNETs]. |url=https://www.washingtonpost.com/health/2022/12/17/stomach-pain-symptoms-diagnosis/ |access-date=2022-12-18 |newspaper=Washington Post |date=17 December 2022 |language=en}}</ref>)

* [[Renal cell carcinoma]]<ref>{{Cite book |last=Guermazi |first=Ali |url=https://books.google.com/books?id=kQgNYqTgdVQC&dq=%22great+imitator%22+-scabies+-lyme+-syphilis+-tuberculosis&pg=PA104 |title=Imaging of Kidney Cancer |date=2005-10-05 |publisher=Springer Science & Business Media |isbn=978-3-540-21129-7 |pages=104 |language=en |quote=Because of its protean and often nonspecific clinical manifestation, RCC is sometimes referred to as the 'great imitator' by clinicians.}}</ref>
* See also: [[#Mass effect inside the cranium|any mass effect inside the cranium]] (including from non-neoplastic causes)
* See also: [[#Mass effect inside the cranium|any mass effect inside the cranium]] (including from non-neoplastic causes)


==Vitamin deficiency==
==Vitamin deficiency==
* [[Thiamine deficiency]], with focus on subclinical forms and nonsevere clinical forms as well as the severe form called beriberi<ref name="Lonsdale-2017">{{cite book |last1=Lonsdale |first1=Derrick |title=Thiamine deficiency disease, dysautonomia, and high calorie malnutrition |date=2017 |publisher=Academic Press |location=London, United Kingdom |isbn=9780128103883}}</ref><ref name="Lonsdale-2015-11-04">{{cite web |last1=Lonsdale |first1=Derrick |title=Beriberi, the Great Imitator |url=http://www.hormonesmatter.com/beriberi-the-great-imitator/ |website=Hormones Matter |publisher=CRM Health and Fitness |access-date=2022-02-14 |date=2015-11-04}}</ref>
* [[Thiamine deficiency]] (vitamin B₁ deficiency), with focus on subclinical forms and nonsevere clinical forms as well as the severe form called beriberi<ref name="Lonsdale-2017">{{cite book |last1=Lonsdale |first1=Derrick |title=Thiamine deficiency disease, dysautonomia, and high calorie malnutrition |date=2017 |publisher=Academic Press |location=London, United Kingdom |isbn=9780128103883}}</ref><ref name="Lonsdale-2015-11-04">{{cite web |last1=Lonsdale |first1=Derrick |title=Beriberi, the Great Imitator |url=http://www.hormonesmatter.com/beriberi-the-great-imitator/ |website=Hormones Matter |publisher=CRM Health and Fitness |access-date=2022-02-14 |date=2015-11-04}}</ref>
** This topic overlaps substantially with the topic of [[excessive alcohol use]], which impairs B₁ metabolism and leads to [[hepatic encephalopathy]]. Relatedly, [[alcohol use disorder]] has been implicated as a great imitator at least once in the medical literature.<ref name="pmid-7004168"/> But the topic of thiamine deficiency also has been identified as an important component not only of [[malnutrition]] in the classic senses of semi[[starvation]] or [[food security|food insecurity]] but also in the sense of high-calorie malnutrition,<ref name="Lonsdale-2017"/><ref name="Lonsdale-2015-11-04"/> even in people who do not use alcohol. [[Hepatic encephalopathy]] is a wide-ranging topic that includes covert, subclinical, minimal, mild, nonalcoholic, alcoholic, moderate, and severe forms, just as (relatedly) [[fatty liver disease]] also has covert, subclinical, minimal, mild, nonalcoholic, alcoholic, moderate, and severe forms. At bottom, it is established that the [[liver]]'s function and the [[gut–brain axis]] affect the brain and thus the mind, although not every [[mind–body problem|correlation]] is understood.
* [[Vitamin B12 deficiency]],<ref>{{Cite web |last=Qazimllari |first=Blerta |title=VITAMIN B12 DEFICIENCY: A GREAT MIMICKER |url=https://www.researchgate.net/publication/374556621 |url-status=live |archive-url=https://web.archive.org/web/20240126041027/https://www.researchgate.net/profile/Jera-Kruja/publication/374556621_Neurological_papers_Tirana_2023/links/6524e505fc5c2a0c3bc7035a/Neurological-papers-Tirana-2023.pdf |archive-date=2024-01-26 |access-date=2024-01-25}}</ref> due to its wide presentation with neurologic, haematologic, psychiatric, and physiological symptoms.<ref>{{Cite journal |last1=Wolffenbuttel |first1=Bruce HR |last2=Owen |first2=P. Julian |last3=Ward |first3=Mary |last4=Green |first4=Ralph |date=2023-11-20 |title=Vitamin B12 |url=https://www.bmj.com/content/383/bmj-2022-071725 |journal=BMJ |language=en |volume=383 |pages=e071725 |doi=10.1136/bmj-2022-071725 |issn=1756-1833 |pmid=37984968|pmc=10658777 }}</ref>

== Substance abuse ==

* [[Substance abuse]] can be confused with medical, psychiatric, and surgical conditions.<ref>{{Cite book |last1=Fatemi |first1=S. Hossein |url=https://books.google.com/books?id=xgLNCwAAQBAJ&dq=%22called+the+great+imitator%22+-tuberculosis+-syphilis&pg=PA281 |title=The Medical Basis of Psychiatry |last2=Clayton |first2=Paula J. |date=2016-03-17 |publisher=Springer |isbn=978-1-4939-2528-5 |pages=281 |language=en |quote=Substance abuse has been called the "great imitator" of our time for good reason.}}</ref>


==Rheumatic diseases (most with autoimmune components)==
==Rheumatic diseases (most with autoimmune components)==
* Various [[rheumatism|rheumatic diseases]], including:
* Various [[rheumatism|rheumatic diseases]], including:
** [[Fibromyalgia]]<ref>[http://www.fibromyalgia-symptoms.org/fibromyalgia_great_imitator.html Fibromyalgia as the great imitator], retrieved December 16th, 2006</ref>
** [[Fibromyalgia]]<ref>[http://www.fibromyalgia-symptoms.org/fibromyalgia_great_imitator.html Fibromyalgia as the great imitator], retrieved December 16th, 2006</ref>
** [[Psoriatic arthritis]]<ref>{{cite web|url=http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/|title=Psoriatic arthritis|date=29 Jan 2017}}</ref>
** [[Psoriatic arthritis]]<ref>{{cite web|url=http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/|title=Psoriatic arthritis|date=29 Jan 2017}}</ref>{{Failed verification|date=December 2024}}
** [[Lupus erythematosus]]<ref>{{cite web|url=http://www.wrongdiagnosis.com/l/lupus/intro.htm|title=Right Care|date=12 June 2014|publisher=}}</ref>
** [[Lupus erythematosus]]<ref>{{cite web|url=http://www.wrongdiagnosis.com/l/lupus/intro.htm|title=Right Care|date=12 June 2014|publisher=}}</ref>
*** [[Systemic lupus erythematosus]]<ref name="pmid15696465">{{cite journal |pmid=15696465 |year=2005 |last1=Bell|first1=JM |last2=Nair |first2=R |last3=Solon |first3=A |last4=Walker |first4=PD |title=SLE: The great imitator strikes again |volume=45 |issue=1 |pages=219–22 |journal=American Journal of Kidney Diseases |doi=10.1053/j.ajkd.2004.05.049}}</ref><ref name="pmid16280927">{{cite journal |pmid=16280927 |year=2005 |last1=Rooney |first1=J |title=Systemic lupus erythematosus: Unmasking a great imitator |volume=35 |issue=11 |pages=54–60; quiz 60–61 |journal=Nursing |doi=10.1097/00152193-200511000-00049|citeseerx=10.1.1.1008.5428 }}</ref>
*** [[Systemic lupus erythematosus]]<ref name="pmid15696465">{{cite journal |pmid=15696465 |year=2005 |last1=Bell|first1=JM |last2=Nair |first2=R |last3=Solon |first3=A |last4=Walker |first4=PD |title=SLE: The great imitator strikes again |volume=45 |issue=1 |pages=219–22 |journal=American Journal of Kidney Diseases |doi=10.1053/j.ajkd.2004.05.049}}</ref><ref name="pmid16280927">{{cite journal |pmid=16280927 |year=2005 |last1=Rooney |first1=J |title=Systemic lupus erythematosus: Unmasking a great imitator |volume=35 |issue=11 |pages=54–60; quiz 60–61 |journal=Nursing |doi=10.1097/00152193-200511000-00049|citeseerx=10.1.1.1008.5428 }}</ref>
** [[Gout]]<ref>{{Cite book |last1=Wolfe |first1=Scott W. |url=https://books.google.com/books?id=cry-CwAAQBAJ&dq=%22great+imitator%22+gout&pg=PA1905 |title=Green's Operative Hand Surgery |last2=Pederson |first2=William C. |last3=Kozin |first3=Scott H. |last4=Cohen |first4=Mark S. |date=2016-02-24 |publisher=Elsevier Health Sciences |isbn=978-0-323-29534-5 |pages=1905 |language=en |quote=Often called “the great imitator,” gout may masquerade as septic arthritis, RA, or neoplasm, and the diagnosis is often delayed by weeks or months.}}</ref>
* A general theme with [[autoimmune disease]]s is that strange signs and symptoms can result (and can make [[differential diagnosis]] difficult) "whenever the body is attacking its own cells in unusual ways"


==Dysplastic diseases, some with precancerous or rheumatologic aspects==
==Dysplastic diseases, some with precancerous or rheumatologic aspects==
* [[Sarcoidosis]]<ref name="pmid-31178106">{{cite journal |last1=Karadağ |first1=AS |last2=Parish |first2=LC |title=Sarcoidosis: a great imitator. |journal=Clinics in dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=240-254 |doi=10.1016/j.clindermatol.2019.01.005 |pmid=31178106}}</ref><ref name="pmid-17173472">{{cite journal |pmid=17173472 |year=2006 |last1=Tchernev |first1=G |title=Cutaneous sarcoidosis: The 'great imitator': Etiopathogenesis, morphology, differential diagnosis, and clinical management |volume=7 |issue=6 |pages=375–82 |journal=American Journal of Clinical Dermatology |doi=10.2165/00128071-200607060-00006|s2cid=12854713 }}</ref>
* [[Sarcoidosis]]<ref name="pmid-31178106">{{cite journal |last1=Karadağ |first1=AS |last2=Parish |first2=LC |title=Sarcoidosis: a great imitator. |journal=Clinics in Dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=240–254 |doi=10.1016/j.clindermatol.2019.01.005 |pmid=31178106|s2cid=81361928 }}</ref><ref name="pmid-17173472">{{cite journal |pmid=17173472 |year=2006 |last1=Tchernev |first1=G |title=Cutaneous sarcoidosis: The 'great imitator': Etiopathogenesis, morphology, differential diagnosis, and clinical management |volume=7 |issue=6 |pages=375–82 |journal=American Journal of Clinical Dermatology |doi=10.2165/00128071-200607060-00006|s2cid=12854713 }}</ref>
* [[Endometriosis]], often misdiagnosed<ref name="pmid-23884896">{{cite journal |last1=Culley |first1=L |last2=Law |first2=C |last3=Hudson |first3=N |last4=Denny |first4=E |last5=Mitchell |first5=H |last6=Baumgarten |first6=M |last7=Raine-Fenning |first7=N |title=The social and psychological impact of endometriosis on women's lives: a critical narrative review. |journal=Human reproduction update |date=November 2013 |volume=19 |issue=6 |pages=625-39 |doi=10.1093/humupd/dmt027 |pmid=23884896}}</ref><ref name="NYT-Gross-2021-04-27">{{cite web |last1=Gross |first1=Rachel E. |orig-date=2021-04-27 |date=2021-04-28 |title=They Call It a 'Women's Disease.' She Wants to Redefine It. Profiles in Science feature. |url=https://www.nytimes.com/2021/04/27/health/endometriosis-griffith-uterus.html |website=The New York Times |access-date=2022-02-14 |archive-url=https://web.archive.org/web/20210429210643/https://www.nytimes.com/2021/04/27/health/endometriosis-griffith-uterus.html |archive-date=2021-04-29 |postscript=. ''Discusses endometriosis, including the themes of misdiagnosis and poor medical understanding as traditionally long-standing problems in this disease.''}}</ref>
* [[Endometriosis]], often misdiagnosed<ref name="pmid-23884896">{{cite journal |last1=Culley |first1=L |last2=Law |first2=C |last3=Hudson |first3=N |last4=Denny |first4=E |last5=Mitchell |first5=H |last6=Baumgarten |first6=M |last7=Raine-Fenning |first7=N |title=The social and psychological impact of endometriosis on women's lives: a critical narrative review. |journal=Human Reproduction Update |date=November 2013 |volume=19 |issue=6 |pages=625–39 |doi=10.1093/humupd/dmt027 |pmid=23884896|doi-access=free |hdl=2086/8845 |hdl-access=free }}</ref><ref name="NYT-Gross-2021-04-27">{{cite web |last1=Gross |first1=Rachel E. |orig-date=2021-04-27 |date=2021-04-28 |title=They Call It a 'Women's Disease.' She Wants to Redefine It. Profiles in Science feature. |url=https://www.nytimes.com/2021/04/27/health/endometriosis-griffith-uterus.html |website=The New York Times |access-date=2022-02-14 |archive-url=https://web.archive.org/web/20210429210643/https://www.nytimes.com/2021/04/27/health/endometriosis-griffith-uterus.html |archive-date=2021-04-29 |postscript=. ''Discusses endometriosis, including the themes of misdiagnosis and poor medical understanding as traditionally long-standing problems in this disease.''}}</ref>


==Neurologic disorders==
==Neurologic disorders==
Line 38: Line 53:
==Gut diseases==
==Gut diseases==
* [[Celiac disease]]<ref>{{cite journal|url=http://www.mja.com.au/public/issues/181_07_041004/woo_fm.html|title=Coeliac disease: the great imitator|first=William|last=Woods|date=1 January 2004|journal=Med. J. Aust.|volume=181|issue=7|page=371|doi=10.5694/j.1326-5377.2004.tb06331.x|pmid=15462655|s2cid=31629803|via=eMJA}}</ref>
* [[Celiac disease]]<ref>{{cite journal|url=http://www.mja.com.au/public/issues/181_07_041004/woo_fm.html|title=Coeliac disease: the great imitator|first=William|last=Woods|date=1 January 2004|journal=Med. J. Aust.|volume=181|issue=7|page=371|doi=10.5694/j.1326-5377.2004.tb06331.x|pmid=15462655|s2cid=31629803|via=eMJA}}</ref>
* Closely related to gut function is liver function; see [[#Vitamin deficiency|information on vitamin bioactivity]]

⚫
===Abdominal inflammations or their mimics===
⚫
* [[Appendicitis]] or its mimics<ref name="pmid-16551787">{{cite journal |last1=Modgil |first1=G |last2=Cooke |first2=DI |last3=Newbury |first3=L |title=Appendiceal appearances: the great imitator. |journal=Archives of Disease in Childhood |date=April 2006 |volume=91 |issue=4 |pages=333 |doi=10.1136/adc.2005.086348 |pmid=16551787|pmc=2065994 }}</ref><ref name="">{{cite journal |last1=Thompson |first1=JP |last2=Selvaraj |first2=D |last3=Nicola |first3=R |title=Mimickers of acute appendicitis |journal=J Am Osteopath Coll Radiol |year=2014 |volume=3 |issue=4 |pages=10–21 |url=https://www.jaocr.org/articles/mimickers-of-acute-appendicitis |access-date=2022-02-11 }}</ref>
⚫
* [[Pancreatitis]]


==Endocrine disorders==
==Endocrine disorders==
* Adrenal insufficiency, especially [[Addison's disease]]<ref name="pmid20609673">{{cite journal |doi=10.1016/j.amjmed.2009.12.027 |title=The Great Imitator|year=2010 |last1=Williams |first1=Penny |last2=Evans |first2=Sorcha |last3=Thachil |first3=Jecko |journal=The American Journal of Medicine |volume=123 |issue=7 |pages=e5 |pmid=20609673}}</ref>
* Adrenal insufficiency, especially [[Addison's disease]]<ref name="pmid20609673">{{cite journal |doi=10.1016/j.amjmed.2009.12.027 |title=The Great Imitator|year=2010 |last1=Williams |first1=Penny |last2=Evans |first2=Sorcha |last3=Thachil |first3=Jecko |journal=The American Journal of Medicine |volume=123 |issue=7 |pages=e5 |pmid=20609673}}</ref>
* [[Hypothyroidism]]<ref name="isbn-9781848001879">{{cite book |last1=Kopp |first1=SA |display-authors=etal |chapter=Cutaneous manifestations of hypothyroidism |editor-last1=Heymann |editor-first1=Warren R. |title=Thyroid disorders with cutaneous manifestations |date=2010 |publisher=Springer Science and Business Media |location=London |isbn=9781848001879}}</ref>
* [[Hypothyroidism]]<ref name="isbn-9781848001879">{{cite book |last1=Kopp |first1=SA |display-authors=etal |chapter=Cutaneous manifestations of hypothyroidism |editor-last1=Heymann |editor-first1=Warren R. |title=Thyroid disorders with cutaneous manifestations |date=2010 |publisher=Springer Science and Business Media |location=London |isbn=9781848001879}}</ref>
* [[Endocrine oncology|Endocrine tumors]]: see [[#Tumors|tumor information]]
* A general theme with [[endocrine disease]]s is that strange signs and symptoms can result (and can make [[differential diagnosis]] difficult) "whenever any endocrine gland or endocrine tumor is secreting hormones in unusual ways (either too much or too little)," because of the very nature of hormones as chemical messengers (thus deranged hormones cause deranged function)


==Thromboembolic events or their mimics==
==Thromboembolic events or their mimics==
* [[Pulmonary embolism]]<ref name="pmid770102">{{cite journal |pmid=770102 |year=1976 |last1=Sharma |first1=GV |last2=Sasahara |first2=AA|last3=McIntyre |first3=KM |title=Pulmonary embolism: The great imitator |volume=22 |issue=7 |pages=4–38 |journal=Disease-a-Month |doi=10.1016/s0011-5029(76)80005-3}}</ref>
* [[Pulmonary embolism]]<ref name="pmid770102">{{cite journal |pmid=770102 |year=1976 |last1=Sharma |first1=GV |last2=Sasahara |first2=AA|last3=McIntyre |first3=KM |title=Pulmonary embolism: The great imitator |volume=22 |issue=7 |pages=4–38 |journal=Disease-a-Month |doi=10.1016/s0011-5029(76)80005-3}}</ref>
* [[Stroke]], stroke mimics, and stroke chameleons<ref name="pmid-30239360">{{cite journal |last1=Moulin |first1=S |last2=Leys |first2=D |title=Stroke mimics and chameleons. |journal=Current opinion in neurology |date=February 2019 |volume=32 |issue=1 |pages=54-59 |doi=10.1097/WCO.0000000000000620 |pmid=30239360}}</ref><ref name="pmid-28551302">{{cite journal |last1=Vilela |first1=P |title=Acute stroke differential diagnosis: Stroke mimics. |journal=European journal of radiology |date=November 2017 |volume=96 |pages=133-144 |doi=10.1016/j.ejrad.2017.05.008 |pmid=28551302}}</ref>
* [[Stroke]], stroke mimics, and stroke chameleons<ref name="pmid-30239360">{{cite journal |last1=Moulin |first1=S |last2=Leys |first2=D |title=Stroke mimics and chameleons. |journal=Current Opinion in Neurology |date=February 2019 |volume=32 |issue=1 |pages=54–59 |doi=10.1097/WCO.0000000000000620 |pmid=30239360|s2cid=52306962 }}</ref><ref name="pmid-28551302">{{cite journal |last1=Vilela |first1=P |title=Acute stroke differential diagnosis: Stroke mimics. |journal=European Journal of Radiology |date=November 2017 |volume=96 |pages=133–144 |doi=10.1016/j.ejrad.2017.05.008 |pmid=28551302}}</ref>
** [[Hypoglycemia]] as an imitator of a [[stroke]]<ref name="pmid-28932374"/>
** [[Hypoglycemia]] as an imitator of a [[stroke]]<ref name="pmid-28932374"/>


==Infectious diseases==
==Infectious diseases==
* Various [[Infection|infectious diseases]], including:
* Various [[Infection|infectious diseases]], including:
** [[Syphilis]]<ref name="pmid-31178101">{{cite journal |last1=Çakmak |first1=SK |last2=Tamer |first2=E |last3=Karadağ |first3=AS |last4=Waugh |first4=M |title=Syphilis: a great imitator. |journal=Clinics in dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=182-191 |doi=10.1016/j.clindermatol.2019.01.007 |pmid=31178101}}</ref><ref name="pmid-32502432">{{cite journal |last1=Keuning |first1=MW |last2=Kamp |first2=GA |last3=Schonenberg-Meinema |first3=D |last4=Dorigo-Zetsma |first4=JW |last5=van Zuiden |first5=JM |last6=Pajkrt |first6=D |title=Congenital syphilis, the great imitator—case report and review. |journal=The Lancet. Infectious diseases |date=July 2020 |volume=20 |issue=7 |pages=e173-e179 |doi=10.1016/S1473-3099(20)30268-1 |pmid=32502432}}</ref><ref name="CDC-on-syphilis">{{cite web|url=https://www.cdc.gov/std/Syphilis/STDFact-Syphilis.htm|title=STD Facts - Syphilis|publisher=|date=2017-12-11}}</ref>
** [[Syphilis]]<ref name="pmid-31178101">{{cite journal |last1=Çakmak |first1=SK |last2=Tamer |first2=E |last3=Karadağ |first3=AS |last4=Waugh |first4=M |title=Syphilis: a great imitator. |journal=Clinics in Dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=182–191 |doi=10.1016/j.clindermatol.2019.01.007 |pmid=31178101|s2cid=80733004 }}</ref><ref name="pmid-32502432">{{cite journal |last1=Keuning |first1=MW |last2=Kamp |first2=GA |last3=Schonenberg-Meinema |first3=D |last4=Dorigo-Zetsma |first4=JW |last5=van Zuiden |first5=JM |last6=Pajkrt |first6=D |title=Congenital syphilis, the great imitator—case report and review. |journal=The Lancet. Infectious Diseases |date=July 2020 |volume=20 |issue=7 |pages=e173–e179 |doi=10.1016/S1473-3099(20)30268-1 |pmid=32502432|s2cid=219398876 }}</ref><ref name="CDC-on-syphilis">{{cite web|url=https://www.cdc.gov/std/Syphilis/STDFact-Syphilis.htm|title=STD Facts - Syphilis|publisher=|date=2017-12-11}}</ref>
** [[Lyme disease]], whose potential as a new great imitator provoked fear in the 1980s and 1990s because of reported cases of misdiagnosis with debilitating consequences;<ref name="pmid-2682960">{{cite journal |last1=Pachner |first1=AR |title=Neurologic manifestations of Lyme disease, the new "great imitator". |journal=Reviews of Infectious Diseases |date=September 1989 |volume=11 Suppl 6 |pages=S1482-6 |doi=10.1093/clinids/11.Supplement_6.S1482 |pmid=2682960}}</ref><ref name="pmid-3292999">{{cite journal |last1=Stechenberg |first1=BW |title=Lyme disease: the latest great imitator. |journal=The Pediatric Infectious Disease Journal |date=June 1988 |volume=7 |issue=6 |pages=402–9 |doi=10.1097/00006454-198806000-00007 |pmid=3292999|s2cid=45395427 }}</ref> today it is generally considered better understood and is treatable, making it no longer quite so fearfully mysterious,<ref name="pmid-25090401">{{cite journal |last1=Melia |first1=MT |last2=Lantos |first2=PM |last3=Auwaerter |first3=PG |title=Lyme disease: authentic imitator or wishful imitation? |journal=JAMA Neurology |date=October 2014 |volume=71 |issue=10 |pages=1209–10 |doi=10.1001/jamaneurol.2014.1193 |pmid=25090401|pmc=4331047 }}</ref> but it remains worthy of consideration with compatible exam findings and when exposure to Lyme-carrying ticks is probable.<ref name="pmid-25090401"/>
** [[Lyme disease]]<ref>[https://query.nytimes.com/gst/fullpage.html?sec=health&res=9F0CE3D71331F930A35753C1A965958260 NYT article on Lyme disease], retrieved December 16th, 2006</ref>
** [[Nocardiosis]]<ref name="pmid15342974">{{cite journal |doi=10.1097/01.md.0000141100.30871.39 |title=A Case Series and Focused Review of Nocardiosis |year=2004 |last1=Lederman |first1=Edith R. |last2=Crum |first2=Nancy F. |journal=Medicine |volume=83 |issue=5 |pages=300–13 |pmid=15342974|s2cid=23940448 }}</ref>
** [[Nocardiosis]]<ref name="pmid15342974">{{cite journal |doi=10.1097/01.md.0000141100.30871.39 |title=A Case Series and Focused Review of Nocardiosis |year=2004 |last1=Lederman |first1=Edith R. |last2=Crum |first2=Nancy F. |journal=Medicine |volume=83 |issue=5 |pages=300–13 |pmid=15342974|s2cid=23940448 |doi-access=free }}</ref>
** [[Tuberculosis]]<ref name="JAMA-1961-TB">{{cite journal |last1=Sievers |first1=Maurice L. |title=The Second "Great Imitator"—Tuberculosis |journal=JAMA |date=3 June 1961 |volume=176 |issue=9 |pages=809–810 |doi=10.1001/JAMA.1961.63040220009017A}}</ref>
** [[Tuberculosis]]<ref name="JAMA-1961-TB">{{cite journal |last1=Sievers |first1=Maurice L. |title=The Second "Great Imitator"—Tuberculosis |journal=JAMA |date=3 June 1961 |volume=176 |issue=9 |pages=809–810 |doi=10.1001/JAMA.1961.63040220009017A}}</ref>
*** [[Pulmonary tuberculosis]]<ref name="JAMA-1961-TB"/>
*** [[Pulmonary tuberculosis]]<ref name="JAMA-1961-TB"/>
*** [[Cutaneous tuberculosis]]<ref name="pmid-31178102">{{cite journal |last1=Chen |first1=Q |last2=Chen |first2=W |last3=Hao |first3=F |title=Cutaneous tuberculosis: a great imitator. |journal=Clinics in dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=192-199 |doi=10.1016/j.clindermatol.2019.01.008 |pmid=31178102}}</ref>
*** [[Cutaneous tuberculosis]]<ref name="pmid-31178102">{{cite journal |last1=Chen |first1=Q |last2=Chen |first2=W |last3=Hao |first3=F |title=Cutaneous tuberculosis: a great imitator. |journal=Clinics in Dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=192–199 |doi=10.1016/j.clindermatol.2019.01.008 |pmid=31178102|s2cid=80862366 }}</ref>
** [[Brucellosis]]
** [[Brucellosis]]
** [[Infective endocarditis]]
** [[Infective endocarditis]]
** [[Malaria]]<ref>http://www.malariasite.com/clinical-features.htm{{Dead link|date=June 2018 |bot=InternetArchiveBot |fix-attempted=no }}</ref>
** [[Malaria]]<ref>http://www.malariasite.com/clinical-features.htm{{Dead link|date=June 2018 |bot=InternetArchiveBot |fix-attempted=no }}</ref>
** [[Leprosy]]<ref name="pmid-31178103">{{cite journal |last1=Kundakci |first1=N |last2=Erdem |first2=C |title=Leprosy: a great imitator. |journal=Clinics in dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=200-212 |doi=10.1016/j.clindermatol.2019.01.002 |pmid=31178103}}</ref>
** [[Leprosy]]<ref name="pmid-31178103">{{cite journal |last1=Kundakci |first1=N |last2=Erdem |first2=C |title=Leprosy: a great imitator. |journal=Clinics in Dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=200–212 |doi=10.1016/j.clindermatol.2019.01.002 |pmid=31178103|s2cid=80817680 }}</ref>
** [[Leishmaniasis]]<ref name="pmid-32513395">{{cite journal |last1=Gurel |first1=MS |last2=Tekin |first2=B |last3=Uzun |first3=S |title=Cutaneous leishmaniasis: a great imitator. |journal=Clinics in dermatology |date=2020-03-01 |volume=38 |issue=2 |pages=140-151 |doi=10.1016/j.clindermatol.2019.10.008 |pmid=32513395}}</ref>
** [[Leishmaniasis]]<ref name="pmid-32513395">{{cite journal |last1=Gurel |first1=MS |last2=Tekin |first2=B |last3=Uzun |first3=S |title=Cutaneous leishmaniasis: a great imitator. |journal=Clinics in Dermatology |date=2020-03-01 |volume=38 |issue=2 |pages=140–151 |doi=10.1016/j.clindermatol.2019.10.008 |pmid=32513395|s2cid=201965975 }}</ref>
** Viral [[exanthem]]s in children<ref name="pmid-31178104">{{cite journal |last1=Knöpfel |first1=N |last2=Noguera-Morel |first2=L |last3=Latour |first3=I |last4=Torrelo |first4=A |title=Viral exanthems in children: a great imitator. |journal=Clinics in dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=213-226 |doi=10.1016/j.clindermatol.2019.01.009 |pmid=31178104}}</ref>
** Viral [[exanthem]]s in children<ref name="pmid-31178104">{{cite journal |last1=Knöpfel |first1=N |last2=Noguera-Morel |first2=L |last3=Latour |first3=I |last4=Torrelo |first4=A |title=Viral exanthems in children: a great imitator. |journal=Clinics in Dermatology |date=2019-05-01 |volume=37 |issue=3 |pages=213–226 |doi=10.1016/j.clindermatol.2019.01.009 |pmid=31178104|s2cid=81488794 }}</ref>
** Gastrointestinal infections: when [[#Abdominal inflammations or their mimics|appendicitis or pancreatitis]] have infectious causes
** [[Rabies]] (prodromal phase)


==Breathing-related sleep disorders (sleep-disordered breathing)==
==Breathing-related sleep disorders (sleep-disordered breathing)==
Line 69: Line 93:
==Proteinopathies==
==Proteinopathies==
* [[Amyloidosis]]
* [[Amyloidosis]]

⚫
==Abdominal inflammations or their mimics==
⚫
* [[Appendicitis]] or its mimics<ref name="pmid-16551787">{{cite journal |last1=Modgil |first1=G |last2=Cooke |first2=DI |last3=Newbury |first3=L |title=Appendiceal appearances: the great imitator. |journal=Archives of disease in childhood |date=April 2006 |volume=91 |issue=4 |pages=333 |doi=10.1136/adc.2005.086348 |pmid=16551787}}</ref><ref name="">{{cite journal |last1=Thompson |first1=JP |last2=Selvaraj |first2=D |last3=Nicola |first3=R |title=Mimickers of acute appendicitis |journal=J Am Osteopath Coll Radiol |year=2014 |volume=3 |issue=4 |pages=10-21 |url=https://www.jaocr.org/articles/mimickers-of-acute-appendicitis |access-date=2022-02-11 |postscript=.}}</ref>
⚫
* [[Pancreatitis]]


==Mass effect inside the cranium==
==Mass effect inside the cranium==
Any [[mass effect (medicine)|mass effect]] inside the cranium (including from non-neoplastic causes):
* Any [[mass effect (medicine)|mass effect]] inside the cranium (including from non-neoplastic causes):
** General theme: "anything inside the head that presses on the brain in unusual ways can cause strange signs or symptoms"
** [[Hydrocephalus]], causing gait disturbances, poor memory, strange behavior, mental impairment, and urinary incontinence, sometimes leading to psychiatric misdiagnoses, especially in cases where the focal neurologic signs are absent; a warning to obtain CT or MRI of the brain to rule out other causes of apparently psychiatric symptoms
** [[Hydrocephalus]], causing gait disturbances, poor memory, strange behavior, mental impairment, and urinary incontinence, sometimes leading to psychiatric misdiagnoses, especially in cases where the focal neurologic signs are absent; a warning to obtain CT or MRI of the brain to rule out other causes of apparently psychiatric symptoms
** [[Intracranial hemorrhage]]: see [[#Thromboembolic events or their mimics|thromboembolic events or their mimics]]
** [[Intracranial hemorrhage]]: see [[#Thromboembolic events or their mimics|thromboembolic events or their mimics]]
** [[Brain tumor]]: see [[#Tumors (neoplasms), especially cancerous tumors or any endocrine tumors|Tumors]]
** [[Brain tumor]]: see [[#Tumors (neoplasms), especially cancerous tumors or any endocrine tumors|Tumors]]

== Skin conditions ==

* [[Scabies]]<ref>{{Cite book |last1=Bieber |first1=Eric J. |url=https://books.google.com/books?id=RfkGBwAAQBAJ&dq=%22great+imitator%22+scabies&pg=PA341 |title=Clinical Gynecology |last2=Sanfilippo |first2=Joseph S. |last3=Horowitz |first3=Ira R. |last4=Shafi |first4=Mahmood I. |date=2015-04-23 |publisher=Cambridge University Press |isbn=978-1-107-04039-7 |pages=341 |language=en |quote=Scabies is called the great imitator because patients can present with a variety of lesions.}}</ref>


==References==
==References==
Line 85: Line 110:
{{DEFAULTSORT:Great Imitator}}
{{DEFAULTSORT:Great Imitator}}
[[Category:Symptoms]]
[[Category:Symptoms]]

{{Disease-stub}}

Latest revision as of 11:02, 3 December 2024

The Great Imitator (also the Great Masquerader) is a phrase used for medical conditions that feature nonspecific symptoms and may be confused with a number of other diseases.[1] The term connotes especially difficult differential diagnosis (DDx), increased potential for misdiagnosis, and the protean nature of some diseases. Most great imitators are systemic in nature or have systemic sequelae, and an aspect of nonspecific symptoms is logically almost always involved. In some cases, an assumption that a particular sign or symptom, or a particular pattern of several thereof, is pathognomonic turns out to be false, as the reality is that it is only nearly so.

As recently as the 1950s, syphilis was widely considered by physicians to be "the great imitator", and in the next few decades after that, several other candidates, mainly tuberculosis[2] but occasionally others,[3] were asserted as being "the second great imitator". But because differential diagnosis is inherently subject to occasional difficulty and to false positives and false negatives, the idea that there are only one or two great imitators was more melodrama than objective description. In recent decades, more than a dozen diseases have been recognized in the medical literature as worthy of being considered great imitators, on the common theme of recurring misdiagnoses/missed diagnoses and protean manifestations. Nonetheless, not every DDx caveat (not every mimic) meets the threshold, because it is inherent to DDx generally that there are thousands of caveats (thousands of instances of the theme, "be careful to rule out X before diagnosing Y"); for example, ectopic pregnancy and ovarian neoplasia can mimic each other, as can myocardial infarction and panic attack, but they are not established as great imitators per se (rather, merely DDx considerations). The list of great imitators here relies on references in the medical literature applying that label, or on other references documenting a condition's especially recurrent and poignant reputation for misdiagnoses.

Conditions or diseases sometimes referred to with this nickname thus include the following:

Low blood sugar

[edit]

Tumors (neoplasms), especially cancerous tumors or any endocrine tumors

[edit]

Vitamin deficiency

[edit]
  • Thiamine deficiency (vitamin B₁ deficiency), with focus on subclinical forms and nonsevere clinical forms as well as the severe form called beriberi[12][13]
    • This topic overlaps substantially with the topic of excessive alcohol use, which impairs B₁ metabolism and leads to hepatic encephalopathy. Relatedly, alcohol use disorder has been implicated as a great imitator at least once in the medical literature.[3] But the topic of thiamine deficiency also has been identified as an important component not only of malnutrition in the classic senses of semistarvation or food insecurity but also in the sense of high-calorie malnutrition,[12][13] even in people who do not use alcohol. Hepatic encephalopathy is a wide-ranging topic that includes covert, subclinical, minimal, mild, nonalcoholic, alcoholic, moderate, and severe forms, just as (relatedly) fatty liver disease also has covert, subclinical, minimal, mild, nonalcoholic, alcoholic, moderate, and severe forms. At bottom, it is established that the liver's function and the gut–brain axis affect the brain and thus the mind, although not every correlation is understood.
  • Vitamin B12 deficiency,[14] due to its wide presentation with neurologic, haematologic, psychiatric, and physiological symptoms.[15]

Substance abuse

[edit]

Rheumatic diseases (most with autoimmune components)

[edit]

Dysplastic diseases, some with precancerous or rheumatologic aspects

[edit]

Neurologic disorders

[edit]

Gut diseases

[edit]

Abdominal inflammations or their mimics

[edit]

Endocrine disorders

[edit]

Thromboembolic events or their mimics

[edit]

Infectious diseases

[edit]
[edit]

Proteinopathies

[edit]

Mass effect inside the cranium

[edit]
  • Any mass effect inside the cranium (including from non-neoplastic causes):
    • General theme: "anything inside the head that presses on the brain in unusual ways can cause strange signs or symptoms"
    • Hydrocephalus, causing gait disturbances, poor memory, strange behavior, mental impairment, and urinary incontinence, sometimes leading to psychiatric misdiagnoses, especially in cases where the focal neurologic signs are absent; a warning to obtain CT or MRI of the brain to rule out other causes of apparently psychiatric symptoms
    • Intracranial hemorrhage: see thromboembolic events or their mimics
    • Brain tumor: see Tumors

Skin conditions

[edit]

References

[edit]
  1. ^ J.C. Segen. The Dictionary of Modern Medicine. CRC Press; 1992. ISBN 978-1-85070-321-1. p. 265.
  2. ^ a b c Sievers, Maurice L. (3 June 1961). "The Second "Great Imitator"—Tuberculosis". JAMA. 176 (9): 809–810. doi:10.1001/JAMA.1961.63040220009017A.
  3. ^ a b Froede, RC; Gordon, JD (November 1980). "Alcoholism--the second great imitator. An introduction to the problem of alcoholism". American Journal of Clinical Pathology. 74 (5): 719–20. doi:10.1093/ajcp/74.5.719. PMID 7004168.
  4. ^ a b Hosseininezhad, M; Sohrabnejad, R (2017). "Stroke mimics in patients with clinical signs of stroke". Caspian Journal of Internal Medicine. 8 (3): 213–216. doi:10.22088/cjim.8.3.213. PMC 5596193. PMID 28932374.
  5. ^ Kufe, Donald W. (2009). Holland-Frei cancer medicine (8th ed.). New York: McGraw-Hill Medical. pp. 1–3. ISBN 978-1-60795-014-1.
  6. ^ Del Paggio, Joseph; et al. (2017). "Disturbances in blood flow and 'medicine's greatest imitator'". Internal Medicine Journal. 47 (5): 586–588. doi:10.1111/imj.13414. PMID 28503874. S2CID 3799976.
  7. ^ Hodak, E; Amitay-Laish, I (2019-05-01). "Mycosis fungoides: a great imitator". Clinics in Dermatology. 37 (3): 255–267. doi:10.1016/j.clindermatol.2019.01.004. PMID 31178107. S2CID 81927761.
  8. ^ Jaros, J; Hunt, S; Mose, E; Lai, O; Tsoukas, M (2020-03-01). "Cutaneous metastases: a great imitator". Clinics in Dermatology. 38 (2): 216–222. doi:10.1016/j.clindermatol.2019.10.004. PMID 32513401. S2CID 208446382.
  9. ^ Kellerman, Rick D.; Rakel, David (2018-12-06). Conn's Current Therapy 2019. Elsevier Health Sciences. p. 971. ISBN 978-0-323-59650-3. Oral cancer has been called the great imitator, for it can appear as many different oral conditions.
  10. ^ a b Boodman, Sandra G. (17 December 2022). "Her crippling digestive problems were caused by a 'zebra' malady [pNETs]". Washington Post. Retrieved 2022-12-18.
  11. ^ Guermazi, Ali (2005-10-05). Imaging of Kidney Cancer. Springer Science & Business Media. p. 104. ISBN 978-3-540-21129-7. Because of its protean and often nonspecific clinical manifestation, RCC is sometimes referred to as the 'great imitator' by clinicians.
  12. ^ a b Lonsdale, Derrick (2017). Thiamine deficiency disease, dysautonomia, and high calorie malnutrition. London, United Kingdom: Academic Press. ISBN 9780128103883.
  13. ^ a b Lonsdale, Derrick (2015-11-04). "Beriberi, the Great Imitator". Hormones Matter. CRM Health and Fitness. Retrieved 2022-02-14.
  14. ^ Qazimllari, Blerta. "VITAMIN B12 DEFICIENCY: A GREAT MIMICKER". Archived (PDF) from the original on 2024-01-26. Retrieved 2024-01-25.
  15. ^ Wolffenbuttel, Bruce HR; Owen, P. Julian; Ward, Mary; Green, Ralph (2023-11-20). "Vitamin B12". BMJ. 383: e071725. doi:10.1136/bmj-2022-071725. ISSN 1756-1833. PMC 10658777. PMID 37984968.
  16. ^ Fatemi, S. Hossein; Clayton, Paula J. (2016-03-17). The Medical Basis of Psychiatry. Springer. p. 281. ISBN 978-1-4939-2528-5. Substance abuse has been called the "great imitator" of our time for good reason.
  17. ^ Fibromyalgia as the great imitator, retrieved December 16th, 2006
  18. ^ "Psoriatic arthritis". 29 Jan 2017.
  19. ^ "Right Care". 12 June 2014.
  20. ^ Bell, JM; Nair, R; Solon, A; Walker, PD (2005). "SLE: The great imitator strikes again". American Journal of Kidney Diseases. 45 (1): 219–22. doi:10.1053/j.ajkd.2004.05.049. PMID 15696465.
  21. ^ Rooney, J (2005). "Systemic lupus erythematosus: Unmasking a great imitator". Nursing. 35 (11): 54–60, quiz 60–61. CiteSeerX 10.1.1.1008.5428. doi:10.1097/00152193-200511000-00049. PMID 16280927.
  22. ^ Wolfe, Scott W.; Pederson, William C.; Kozin, Scott H.; Cohen, Mark S. (2016-02-24). Green's Operative Hand Surgery. Elsevier Health Sciences. p. 1905. ISBN 978-0-323-29534-5. Often called "the great imitator," gout may masquerade as septic arthritis, RA, or neoplasm, and the diagnosis is often delayed by weeks or months.
  23. ^ Karadağ, AS; Parish, LC (2019-05-01). "Sarcoidosis: a great imitator". Clinics in Dermatology. 37 (3): 240–254. doi:10.1016/j.clindermatol.2019.01.005. PMID 31178106. S2CID 81361928.
  24. ^ Tchernev, G (2006). "Cutaneous sarcoidosis: The 'great imitator': Etiopathogenesis, morphology, differential diagnosis, and clinical management". American Journal of Clinical Dermatology. 7 (6): 375–82. doi:10.2165/00128071-200607060-00006. PMID 17173472. S2CID 12854713.
  25. ^ Culley, L; Law, C; Hudson, N; Denny, E; Mitchell, H; Baumgarten, M; Raine-Fenning, N (November 2013). "The social and psychological impact of endometriosis on women's lives: a critical narrative review". Human Reproduction Update. 19 (6): 625–39. doi:10.1093/humupd/dmt027. hdl:2086/8845. PMID 23884896.
  26. ^ Gross, Rachel E. (2021-04-28) [2021-04-27]. "They Call It a 'Women's Disease.' She Wants to Redefine It. Profiles in Science feature". The New York Times. Archived from the original on 2021-04-29. Retrieved 2022-02-14. Discusses endometriosis, including the themes of misdiagnosis and poor medical understanding as traditionally long-standing problems in this disease.{{cite web}}: CS1 maint: postscript (link)
  27. ^ Multiple Sclerosis as the great imitator Archived 2009-01-04 at the Wayback Machine, retrieved December 16th, 2006
  28. ^ Woods, William (1 January 2004). "Coeliac disease: the great imitator". Med. J. Aust. 181 (7): 371. doi:10.5694/j.1326-5377.2004.tb06331.x. PMID 15462655. S2CID 31629803 – via eMJA.
  29. ^ Modgil, G; Cooke, DI; Newbury, L (April 2006). "Appendiceal appearances: the great imitator". Archives of Disease in Childhood. 91 (4): 333. doi:10.1136/adc.2005.086348. PMC 2065994. PMID 16551787.
  30. ^ Thompson, JP; Selvaraj, D; Nicola, R (2014). "Mimickers of acute appendicitis". J Am Osteopath Coll Radiol. 3 (4): 10–21. Retrieved 2022-02-11.
  31. ^ Williams, Penny; Evans, Sorcha; Thachil, Jecko (2010). "The Great Imitator". The American Journal of Medicine. 123 (7): e5. doi:10.1016/j.amjmed.2009.12.027. PMID 20609673.
  32. ^ Kopp, SA; et al. (2010). "Cutaneous manifestations of hypothyroidism". In Heymann, Warren R. (ed.). Thyroid disorders with cutaneous manifestations. London: Springer Science and Business Media. ISBN 9781848001879.
  33. ^ Sharma, GV; Sasahara, AA; McIntyre, KM (1976). "Pulmonary embolism: The great imitator". Disease-a-Month. 22 (7): 4–38. doi:10.1016/s0011-5029(76)80005-3. PMID 770102.
  34. ^ Moulin, S; Leys, D (February 2019). "Stroke mimics and chameleons". Current Opinion in Neurology. 32 (1): 54–59. doi:10.1097/WCO.0000000000000620. PMID 30239360. S2CID 52306962.
  35. ^ Vilela, P (November 2017). "Acute stroke differential diagnosis: Stroke mimics". European Journal of Radiology. 96: 133–144. doi:10.1016/j.ejrad.2017.05.008. PMID 28551302.
  36. ^ Çakmak, SK; Tamer, E; Karadağ, AS; Waugh, M (2019-05-01). "Syphilis: a great imitator". Clinics in Dermatology. 37 (3): 182–191. doi:10.1016/j.clindermatol.2019.01.007. PMID 31178101. S2CID 80733004.
  37. ^ Keuning, MW; Kamp, GA; Schonenberg-Meinema, D; Dorigo-Zetsma, JW; van Zuiden, JM; Pajkrt, D (July 2020). "Congenital syphilis, the great imitator—case report and review". The Lancet. Infectious Diseases. 20 (7): e173–e179. doi:10.1016/S1473-3099(20)30268-1. PMID 32502432. S2CID 219398876.
  38. ^ "STD Facts - Syphilis". 2017-12-11.
  39. ^ Pachner, AR (September 1989). "Neurologic manifestations of Lyme disease, the new "great imitator"". Reviews of Infectious Diseases. 11 Suppl 6: S1482-6. doi:10.1093/clinids/11.Supplement_6.S1482. PMID 2682960.
  40. ^ Stechenberg, BW (June 1988). "Lyme disease: the latest great imitator". The Pediatric Infectious Disease Journal. 7 (6): 402–9. doi:10.1097/00006454-198806000-00007. PMID 3292999. S2CID 45395427.
  41. ^ a b Melia, MT; Lantos, PM; Auwaerter, PG (October 2014). "Lyme disease: authentic imitator or wishful imitation?". JAMA Neurology. 71 (10): 1209–10. doi:10.1001/jamaneurol.2014.1193. PMC 4331047. PMID 25090401.
  42. ^ Lederman, Edith R.; Crum, Nancy F. (2004). "A Case Series and Focused Review of Nocardiosis". Medicine. 83 (5): 300–13. doi:10.1097/01.md.0000141100.30871.39. PMID 15342974. S2CID 23940448.
  43. ^ Chen, Q; Chen, W; Hao, F (2019-05-01). "Cutaneous tuberculosis: a great imitator". Clinics in Dermatology. 37 (3): 192–199. doi:10.1016/j.clindermatol.2019.01.008. PMID 31178102. S2CID 80862366.
  44. ^ http://www.malariasite.com/clinical-features.htm[permanent dead link‍]
  45. ^ Kundakci, N; Erdem, C (2019-05-01). "Leprosy: a great imitator". Clinics in Dermatology. 37 (3): 200–212. doi:10.1016/j.clindermatol.2019.01.002. PMID 31178103. S2CID 80817680.
  46. ^ Gurel, MS; Tekin, B; Uzun, S (2020-03-01). "Cutaneous leishmaniasis: a great imitator". Clinics in Dermatology. 38 (2): 140–151. doi:10.1016/j.clindermatol.2019.10.008. PMID 32513395. S2CID 201965975.
  47. ^ Knöpfel, N; Noguera-Morel, L; Latour, I; Torrelo, A (2019-05-01). "Viral exanthems in children: a great imitator". Clinics in Dermatology. 37 (3): 213–226. doi:10.1016/j.clindermatol.2019.01.009. PMID 31178104. S2CID 81488794.
  48. ^ Bieber, Eric J.; Sanfilippo, Joseph S.; Horowitz, Ira R.; Shafi, Mahmood I. (2015-04-23). Clinical Gynecology. Cambridge University Press. p. 341. ISBN 978-1-107-04039-7. Scabies is called the great imitator because patients can present with a variety of lesions.
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