There a few diseases which quite resemble an other disease in presentation and sometimes pathology.Here's a list I made-
1. Wolf-Parkinson-White and
Lown-Ganong-Levine syndrome-
-What's similar?
The tachycardia, short PR
interval, pre- excitation
-What's different?
While in WPW syndrome,the
culprit is a naughty extra pathway,
the bundle of Kent, in LGL the AV
node itself is naughty.(The
hypothesized bundle of James
hasn't been discovered yet)
Conduction through the AV node
occurs rapidly.
ECG findings- WPW syndrome has
a short PR interval and a Delta
wave on the QRS complex. No
Delta waves occur in the LGL
syndrome.
Also, the risk of sudden death
remains lower in LGL syndrome.
2. Myasthenia Gravis and Lambert
Eaton syndrome.
-What's similar?
The muscle weakness.
-What's different?
Oh almost everything. In MG,
autoantibodies are formed against
the nicotinic receptors whilst in
LEMS(Lambert Eaton myasthenic
syndrome), the antibodies are
against 'pre synaptic voltage
gated Calcium channels'.
LEMS is mostly associated with
underlying malignancies,
making it a paraneoplastic
syndrome.
In contrast to MG, where
distal musculature is affected
the most, proximal musculature
gets involved in LEMS. Arm
muscles are frequently involved
while MG prefers muscles of the
leg.
The autonomic nervous system
also may be affected in LEMS.
The most significant difference
is that the strength actually
improves on exertion in LEMS,
known as 'Lambert's sign',
whereas in MG, weakness
prevails on repeated activity.
3. Multiple sclerosis and Devic's
disease
-What's similar?
The demyelination and
associated CNS symptoms.
-What's different?
Many things. The optic nerve
and spinal cord are affected more
commonly in Devic's. MS affects
the CNS as a whole.
Devic's runs a more serious
course than MS, the morbidity
after an attack is more severe
compared to it.
MS is a T cell mediated
autoimmune disease while IgG
antibodies mediate Devic's, more
specifically the
NMO(neuromyelitis optica)IgG.
Oligoclonal bands are rare in
Devic's, and disappear after
an attack.
Uhthoff's phenomenon, where
symptoms worsen after exposure
to higher temperatures,and the
Lhermitte's sign, where sudden,
shock like sensation travelling
through the spinal cord is felt,
occur more commonly in MS.
4.Plague and Tularemia.
-What's similar?
Those large, pus filled lymph
nodes.
-What's different?
Everything.Francisella
tularensis is the causative agent,
ticks and arthropods are the
vectors, rabbits are the source,
so on and so forth!
1. Wolf-Parkinson-White and
Lown-Ganong-Levine syndrome-
-What's similar?
The tachycardia, short PR
interval, pre- excitation
-What's different?
While in WPW syndrome,the
culprit is a naughty extra pathway,
the bundle of Kent, in LGL the AV
node itself is naughty.(The
hypothesized bundle of James
hasn't been discovered yet)
Conduction through the AV node
occurs rapidly.
ECG findings- WPW syndrome has
a short PR interval and a Delta
wave on the QRS complex. No
Delta waves occur in the LGL
syndrome.
Also, the risk of sudden death
remains lower in LGL syndrome.
2. Myasthenia Gravis and Lambert
Eaton syndrome.
-What's similar?
The muscle weakness.
-What's different?
Oh almost everything. In MG,
autoantibodies are formed against
the nicotinic receptors whilst in
LEMS(Lambert Eaton myasthenic
syndrome), the antibodies are
against 'pre synaptic voltage
gated Calcium channels'.
LEMS is mostly associated with
underlying malignancies,
making it a paraneoplastic
syndrome.
In contrast to MG, where
distal musculature is affected
the most, proximal musculature
gets involved in LEMS. Arm
muscles are frequently involved
while MG prefers muscles of the
leg.
The autonomic nervous system
also may be affected in LEMS.
The most significant difference
is that the strength actually
improves on exertion in LEMS,
known as 'Lambert's sign',
whereas in MG, weakness
prevails on repeated activity.
3. Multiple sclerosis and Devic's
disease
-What's similar?
The demyelination and
associated CNS symptoms.
-What's different?
Many things. The optic nerve
and spinal cord are affected more
commonly in Devic's. MS affects
the CNS as a whole.
Devic's runs a more serious
course than MS, the morbidity
after an attack is more severe
compared to it.
MS is a T cell mediated
autoimmune disease while IgG
antibodies mediate Devic's, more
specifically the
NMO(neuromyelitis optica)IgG.
Oligoclonal bands are rare in
Devic's, and disappear after
an attack.
Uhthoff's phenomenon, where
symptoms worsen after exposure
to higher temperatures,and the
Lhermitte's sign, where sudden,
shock like sensation travelling
through the spinal cord is felt,
occur more commonly in MS.
4.Plague and Tularemia.
-What's similar?
Those large, pus filled lymph
nodes.
-What's different?
Everything.Francisella
tularensis is the causative agent,
ticks and arthropods are the
vectors, rabbits are the source,
so on and so forth!
Very Nice post!! I used to get confuse between theses diseases but you made them simple!
ReplyDeleteThanks Vishal!
DeleteGood one 👍😊
ReplyDeleteThank you Bhavana!
DeleteNice one 🤘🏻👌🏻
ReplyDeleteThanks Deep. Good to know you liked it!
ReplyDelete