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==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]] (beriberi)


==Rheumatic diseases (most with autoimmune components)==
==Rheumatic diseases (most with autoimmune components)==

Revision as of 03:20, 15 February 2022

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), especial 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

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

Vitamin deficiency

  • Thiamine deficiency, with focus on subclinical forms and nonsevere clinical forms as well as the severe form called beriberi[9][10]

Rheumatic diseases (most with autoimmune components)

Dysplastic diseases, some with precancerous or rheumatologic aspects

Neurologic disorders

Gut diseases

Endocrine disorders

Thromboembolic events or their mimics

Infectious diseases

Proteinopathies

Abdominal inflammations or their mimics

Mass effect inside the cranium

  • 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.

References

  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. ^ 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. 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.
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  9. ^ Lonsdale, Derrick (2017). Thiamine deficiency disease, dysautonomia, and high calorie malnutrition. London, United Kingdom: Academic Press. ISBN 9780128103883.
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  20. ^ Multiple Sclerosis as the great imitator Archived 2009-01-04 at the Wayback Machine, retrieved December 16th, 2006
  21. ^ 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.
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  23. ^ 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.
  24. ^ 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.
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  26. ^ 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.
  27. ^ 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.
  28. ^ 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.
  29. ^ "STD Facts - Syphilis". 2017-12-11.
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  32. ^ 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.
  33. ^ http://www.malariasite.com/clinical-features.htm[permanent dead link‍]
  34. ^ 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.
  35. ^ 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.
  36. ^ 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.
  37. ^ 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. PMID 16551787.
  38. ^ Thompson, JP; Selvaraj, D; Nicola, R (2014). "Mimickers of acute appendicitis". J Am Osteopath Coll Radiol. 3 (4): 10–21. Retrieved 2022-02-11.{{cite journal}}: CS1 maint: postscript (link)
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