"Diseases to Consider"

I'm Ed Friedlander MD, an autopsy and classroom pathologist with a strong social conscience.

I'm not your doctor.

Here's a list, compiled from twenty years of experience and study, of diseases in a special category -- "Diseases to Consider". It's my own term.

The definining features of a "Disease to Consider" are...

I have not included such entities as pulmonary embolus or lupus, for which most physicians have a good index of suspicion. I have not included amyloidosis or Creutzfeldt-Jacob disease, which are easy to miss but is not very treatable. I have not included such entities as arrhythmogenic right ventricular cardiomyopathy, which typically presents as sudden, unexpected death.

Click on the name of the disease and it will take you to the corresponding site in Ed's Pathology Notes, the internet's largest public pathology information site.

Addison's Disease: Your headaches, sick-stomach, and personality changes are likely to get you a psychiatric diagnosis -- until you die suddenly.

Arsenic Poisoning: This can mimic a host of "functional diseases". This favorite homicidal poison is easily obtained and easily administered.

Brucellosis: A mimic of many different "functional" diseases, especially in those who have worked around livestock.

Carbon Monoxide Poisoning: Caused by a faulty home heater, the whole family just feels headachey and bad. But what if you're the only one in the house?

Carcinoid Syndrome: The flusing looks like a "rash". The wheezing looks like "asthma". The diarrhea looks like "spastic colon".

Cushing's Syndrome: There are so many overweight, diabetic, hypertensive people that only your personality changes and malaise get noticed, and you end up at the psychiatrist's.

Cryoglobulinemia: Arthritis, spots on the feet, kidney problems, blanching fingers -- a situation, sometimes the harbinger of other disease, that's hard to diagnose just because the key test is so simple.

Dystonia Musculorum Deformans: "Human pretzel disease", in which muscle tone is altered in strange ways. Easily mistaken for emotional illness.

Eaton-Lambert: A very common herald of a very common lung cancer. Your weak muscles puzzle you and your doctor. The lung cancer can't be cured, but it can be slowed down -- and your life made better -- for a few good months.

Endocarditis: "Just the 'flu"... until it causes death or worse.

Folic Acid Deficiency: Present in marginal quantities even in the average American diet, deficiency in this vitamin can make you crazy before it makes you anemic. Worse, some people need much, much more than others. "Subclinical" folic acid deficiency is (in my opinion) much under-diagnosed.

Glanders and Pseudoglanders: Picked up in the poor nations, these bacteria are hard to kill, and can cause lingering ill-health.

Hyperparathyroidism: This can send you to the psychiatrist for years.

Hyperthyroidism: You can be treated for "nerves", "panic attacks", or whatever -- until disaster strikes.

Hypopituitarism: Without a really good medical history-taking, you'll probably be given a psychiatric diagnosis.

Hypothyroidism: You can end up being treated for "depression" or warehoused as a "schizophrenic".

Insulinoma: Someone just starts gaining weight and/or starts "getting psychiatric".

Ectodermal Dysplasia: A young child does poorly in warm weather -- because the sweat glands failed to develop.

Iron Overload: Liver disease? Diabetes? Heart trouble? Failing libido? Just not feeling right? "Hemochromatosis" gets missed a lot -- with disastrous results.

Lead Poisoning: From industry, moonshine, or paint chips, it can send you to the psychiatrist.

Lyme Disease: This can be a near-perfect mimic for multiple sclerosis, any of several arthritis syndromes, or simply baffle. The blood tests are still unreliable.

Manganese Poisoning: A perfect mimic of common Parkinson's disease.

Meningioma: You can end up at the care of the psychiatrist for years before this brain tumor finally gets big enough to give you a headache.

Mixed Connective Tissue Disease: Or "antiribonucleoprotein disease", this can look like many different chronic diseases.

Normal Pressure Hydrocephalus: A mimic of "Alzheimer's disease", a simply surgical intervention can restore clear thinking.

Mercury Poisoning: Subtle industrial or laboratory exposure can land you at the psychiatrist's -- while irreversible brain damage is still underway.

Temporal Arteritis: An older person has "tension headaches" or "rheumatism due to old age". Miss the diagnosis and blindness or stroke results.

Paraneoplastic Encephalopathy: The immune response against a hidden cancer (perhaps curable) cross-reacts with the brain, sending you to the psychiatrist's office.

Polyarteritis Nodosa: Perhaps the most protean of all diseases. Patient can be considered hypochondriacs for years -- and when the diagnosis is obvious, it's too late.

Periodic Paralysis: Several diseases in which the muscles go weak, perhaps after exertion. Less treatable than most of these -- but one you'll need to understand if it affects you.

Pheochromocytoma: Easily mistaken for "common headaches", "mental illness", "functional hypoglycemia", and/or "high blood pressure". The lab diagnosis of "pheo" is notoriously untrustworthy.

Polymyositis: Easily mistaken for "rheumatism".

Porphyria: Easily mistaken for "spastic colon" and/or "mental illness". Disturbingly common.

Thallium Poisoning: This homicidal poison is relatively easy to obtain. The results of a non-lethal dose are very easy to mistake for the 'flu.

Prolactinoma: A man's libido drops off; a woman's periods become irregular or stop. No one thinks anything of it -- until it's too late.

Sarcoidosis: One of the great imitators. Remember it's in the differential diagnosis of personality change and dementia.

Sleep Apnea: School failure, job failure, marital failure, brain damage, death on the highway. From SNORING? Yup.

Sporotrichosis: Biopsy and culture are much less likely to explain your mysterious rash than simply remembering you pricked yourself on a thorn.

Subdural Hematoma: Miss a chronic one, and you're doomed to spend the rest of your life as an "Alzheimer's" or "stroke" patient.

Syphilis: Still with us, and it's sent more than a few people to the psychiatrist for "functional psychosis", the neurologist for "migraine", or the nursing home for "dementia".

Temporal Arteritis: "Tension headache", maybe with "rheumatism". Until you have a stroke and/or go permanently blind.

Vitamin B12 deficiency: Not from a poor diet but from hidden disease... its presentation is easily mistaken for "Alzheimer's disease" or some other brain disease. Disturbingly common.

Wegener's Granulomatosis: Patients are troubled for years with nose, ear, eye, and/or joint problems. An intensive investigation of the small lesion on the chest x-ray or the trace of blood in the urine may finally yield the diagnosis -- but these clues may not even be present.

Whipple's Disease: This can present as mental changes long before the intestinal problems become obvious.

Wilson's Disease: Your elevated liver enzymes, your mild hemolysis, and your slightly abnormal urinalysis don't attract notice, and your mental changes get blamed on "stress" -- until irreversible harm is done.

I hope you are healthy, and that you do what you can to protect yourself. The human body is designed to wear out, and many diseases are not preventable and/or not curable. This site is offered with the hope that occasional visitors will recognize themselves, or someone else. Best regards to all who come here. Health and friendship.

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