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Misdiagnosis of
Look-Alike Illnesses.
Misdiagnosis is a
much more widespread problem in healthcare than most know.
A Mayo Clinic study found that the true cause of death in
20% of patients autopsied had been missed or misdiagnosed.
The financial cost in litigation is huge but is nothing
compared to the human suffering which often goes on for years in
the lives of patients.
Lisa Sanders,
author of the Diagnosis column in the New York Times Magazine
states that there are three main reasons underlying
misdiagnosis: mistakes
in how doctors think; over reliance on specialists and medical
testing; and the human body which can have a limited number of
ways of exhibiting many ailments.
One situation in
which misdiagnosis is overly common is when disorders share
symptoms or "look alike".
Some of the most confusing detailed in the July/August
2011 AARP Magazine are as follows**:
Disease:
Lupus - a
chronic inflammatory autoimmune disease
Symptoms:
Fatigue; kidney, heart and lung damage;
rash; joint pain
Mimics:
Chronic
Fatigue Syndrome; Fibromyalgia; Rheumatoid Arthritis
Tests:
Complete blood count to assess presence of anemia and a
decrease white blood cell count; chest X-ray that may show
pleurisy or lupus-related pneumonia; anti-double-stranded DNA
test (anti-dsDNA), currently the most specific lupus test; ANA
and lupus erythematosus cell tests which may show positive in
active lupus.
Disease:
Fibromyalgia
- a chronic arthritis-like disorder characterized by
widespread pain
Symptoms: Muscle and joint pain; 11 of 18 painful
tender points; increased sensitivity to pain; incapacitating
fatigue; memory, attention and concentration problems; anxiety
and depression
Mimics: Lupus;
Rheumatoid Arthtritis; Chronic Fatigue Syndrome; Lyme Disease
Tests:
No diagnostic lab tests available; however, a diagnosis
is usually made when patients reports two symptoms: 1. history
of widespread pain in body's quadrants; and 2. the presence of
at least 11 tender points, spots on the body extraordinarily
sensitive to pain.
Disease:
Chronic
Fatigue Syndrome - a complex disorder with a combination
of symptoms of unknown origin
Symptoms:
Loss of memory or concentration; sore
throat; extreme exhaustion; unexplained muscle and joint pain;
painful neck or armpit lymph nodes
Mimics:
Fibromyalgia;
Lupus; Rheumatoid Arthritis; Sinus Problems; Hepatitis
Tests:
No lab or other diagnostic procedures to confirm
presence. Diagnosis is based on exclusion of similar disorders.
Disease:
Celiac
Disease - an autoimmune disease caused by an inability to digest
gluten (a protein in wheat, rye and barley)
Symptoms:
Vomiting; abdominal pain and bloating;
diarrhea; weight loss; anemia; leg cramps
Mimics:
Irritable
Bowel Syndrome; Crohn's Disease; Cystic Fibrosis
Tests: Blood tests detect high levels of some antibodies;
however about 10% of those with Celiac test negative.
Small-intestine-sample biopsy. Genetic (DNA) tests.
Disease: Multiple
Sclerosis - a progressive autoimmune disease that attacks the
central nervous system
Symptoms:
Muscle spasms; lack of coordination;
balance difficulties; blurred vision; cognitive impairment
Mimics:
Lupus;
Alzheimer's; Viral Infection; Bipolar Disorder
Tests:
Blood tests to rule out other disorder. A lumbar
puncture. An MRI which may show the brain and spinal cord damage
and lesions characteristic of MS.
Disease:
Lyme
Disease - A systemic infection caused by a tick bite
Symptoms:
Shortness of breath; nausea; vomiting;
chest or rib soreness; abdominal cramping; bull's eye rash at
bite site; neck stiffness; face or eyelid twitching
Mimics:Fibromyalgia;
Chronic Fatigue Syndrome; Mononucleosis; Depression; Meningitis
Tests:
If no rash is visible, a 2-step blood antibody test is
suggested: the ELISA or IFA blood test followed by the Western
blot blood test.
**
Some of these conditions will be described in much
greater detail in other articles appearing in The Fibromyalgia Digest.
To learn more about Dr. Ravicz's work purchase a copy Thriving
With Your Autoimmune Disorder below.
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