Jump to content

The Great Imitator

From Wikipedia, the free encyclopedia

This is an old revision of this page, as edited by Quercus solaris (talk | contribs) at 06:54, 15 February 2022. The present address (URL) is a permanent link to this revision, which may differ significantly from the current revision.

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

Any mass effect inside the cranium (including from non-neoplastic causes):

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.
  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.
  9. ^ Lonsdale, Derrick (2017). Thiamine deficiency disease, dysautonomia, and high calorie malnutrition. London, United Kingdom: Academic Press. ISBN 9780128103883.
  10. ^ Lonsdale, Derrick (2015-11-04). "Beriberi, the Great Imitator". Hormones Matter. CRM Health and Fitness. Retrieved 2022-02-14.
  11. ^ Fibromyalgia as the great imitator, retrieved December 16th, 2006
  12. ^ "Psoriatic arthritis". 29 Jan 2017.
  13. ^ "Right Care". 12 June 2014.
  14. ^ 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.
  15. ^ 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.
  16. ^ 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.
  17. ^ 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.
  18. ^ 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. PMID 23884896.
  19. ^ 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)
  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.
  22. ^ 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.
  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.
  25. ^ 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.
  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.
  30. ^ NYT article on Lyme disease, retrieved December 16th, 2006
  31. ^ 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.
  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)
Stub icon

This article about a disease, disorder, or medical condition is a stub. You can help Wikipedia by expanding it.

Retrieved from "https://en.wikipedia.org/enwiki/w/index.php?title=The_Great_Imitator&oldid=1071956099"