POEMS syndrome differential diagnosis: Difference between revisions
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| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''POEMS syndrome (Demyelinating)'''<ref name="pmid8608236">{{cite journal |vauthors=Gherardi RK, Bélec L, Soubrier M, Malapert D, Zuber M, Viard JP, Intrator L, Degos JD, Authier FJ |title=Overproduction of proinflammatory cytokines imbalanced by their antagonists in POEMS syndrome |journal=Blood |volume=87 |issue=4 |pages=1458–65 |date=February 1996 |pmid=8608236 |doi= |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''POEMS syndrome (Demyelinating)'''<ref name="pmid8608236">{{cite journal |vauthors=Gherardi RK, Bélec L, Soubrier M, Malapert D, Zuber M, Viard JP, Intrator L, Degos JD, Authier FJ |title=Overproduction of proinflammatory cytokines imbalanced by their antagonists in POEMS syndrome |journal=Blood |volume=87 |issue=4 |pages=1458–65 |date=February 1996 |pmid=8608236 |doi= |url=}}</ref> | ||
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* Monoclonal plasma cell proliferation | * [[Monoclonal]] [[plasma cell]] proliferation | ||
* Cytokine storm (IL-1, IL-6, IL-12, TNF alpha, VEGF) | * Cytokine storm (IL-1, IL-6, IL-12, TNF alpha, VEGF) | ||
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* Symmetrical, ascending chronic progressive [[polyneuropathy]] with both [[Sensory system|sensory]] (pin-prick and vibration) and motor disability (motor > sensory) | * Symmetrical, ascending chronic progressive [[polyneuropathy]] with both [[Sensory system|sensory]] (pin-prick and vibration) and [[Motor skill|motor]] disability ([[Motor skill|motor]] > [[sensory]]) | ||
* Generalized/extermity pain | * Generalized/extermity [[pain]] | ||
* Areflexia | * [[Areflexia]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*Increased number of [[Platelet|thrombocytes]]<ref name="pmid28894560">{{cite journal |vauthors=Nozza A |title=POEMS SYNDROME: an Update |journal=Mediterr J Hematol Infect Dis |volume=9 |issue=1 |pages=e2017051 |date=2017 |pmid=28894560 |pmc=5584767 |doi=10.4084/MJHID.2017.051 |url=}}</ref><ref name="pmid6248720">{{cite journal |vauthors=Bardwick PA, Zvaifler NJ, Gill GN, Newman D, Greenway GD, Resnick DL |title=Plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes: the POEMS syndrome. Report on two cases and a review of the literature |journal=Medicine (Baltimore) |volume=59 |issue=4 |pages=311–22 |date=July 1980 |pmid=6248720 |doi= |url=}}</ref><ref name="pmid6315993">{{cite journal |vauthors=Takatsuki K, Sanada I |title=Plasma cell dyscrasia with polyneuropathy and endocrine disorder: clinical and laboratory features of 109 reported cases |journal=Jpn. J. Clin. Oncol. |volume=13 |issue=3 |pages=543–55 |date=September 1983 |pmid=6315993 |doi= |url=}}</ref> | *Increased number of [[Platelet|thrombocytes]]<ref name="pmid28894560">{{cite journal |vauthors=Nozza A |title=POEMS SYNDROME: an Update |journal=Mediterr J Hematol Infect Dis |volume=9 |issue=1 |pages=e2017051 |date=2017 |pmid=28894560 |pmc=5584767 |doi=10.4084/MJHID.2017.051 |url=}}</ref><ref name="pmid6248720">{{cite journal |vauthors=Bardwick PA, Zvaifler NJ, Gill GN, Newman D, Greenway GD, Resnick DL |title=Plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes: the POEMS syndrome. Report on two cases and a review of the literature |journal=Medicine (Baltimore) |volume=59 |issue=4 |pages=311–22 |date=July 1980 |pmid=6248720 |doi= |url=}}</ref><ref name="pmid6315993">{{cite journal |vauthors=Takatsuki K, Sanada I |title=Plasma cell dyscrasia with polyneuropathy and endocrine disorder: clinical and laboratory features of 109 reported cases |journal=Jpn. J. Clin. Oncol. |volume=13 |issue=3 |pages=543–55 |date=September 1983 |pmid=6315993 |doi= |url=}}</ref> | ||
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*Elevated levels of antitiroglobulin [[antibody]] and antithyroid peroxydase [[antibody]]<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | *Elevated levels of antitiroglobulin [[antibody]] and antithyroid peroxydase [[antibody]]<ref name="pmid25888197">{{cite journal |vauthors=Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK |title=POEMS syndrome with peripheral and central nervous system demyelination: case report |journal=Neurologist |volume=19 |issue=4 |pages=101–3 |date=April 2015 |pmid=25888197 |doi=10.1097/NRL.0000000000000017 |url=}}</ref> | ||
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* International Myeloma Working Group (IMWG) clinical and laboratory diagnostic criteria<ref name="urlIMWG | International Myeloma Working Group (IMWG) Criteria for the Diagnosis of Multiple Myeloma">{{cite web |url=http://imwg.myeloma.org/international-myeloma-working-group-imwg-criteria-for-the-diagnosis-of-multiple-myeloma/ |title=IMWG | International Myeloma Working Group (IMWG) Criteria for the Diagnosis of Multiple Myeloma |format= |work= |accessdate=}}</ref> | * [[POEMS syndrome diagnostic criteria|International Myeloma Working Group (IMWG) clinical and laboratory diagnostic criteria]]<ref name="urlIMWG | International Myeloma Working Group (IMWG) Criteria for the Diagnosis of Multiple Myeloma">{{cite web |url=http://imwg.myeloma.org/international-myeloma-working-group-imwg-criteria-for-the-diagnosis-of-multiple-myeloma/ |title=IMWG | International Myeloma Working Group (IMWG) Criteria for the Diagnosis of Multiple Myeloma |format= |work= |accessdate=}}</ref> | ||
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|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Metabolic Syndrome (Axonal pathology)'''<ref name="pmid25897354">{{cite journal |vauthors=Schreiber AK, Nones CF, Reis RC, Chichorro JG, Cunha JM |title=Diabetic neuropathic pain: Physiopathology and treatment |journal=World J Diabetes |volume=6 |issue=3 |pages=432–44 |date=April 2015 |pmid=25897354 |doi=10.4239/wjd.v6.i3.432 |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Metabolic syndrome|Metabolic Syndrome]] (Axonal pathology)'''<ref name="pmid25897354">{{cite journal |vauthors=Schreiber AK, Nones CF, Reis RC, Chichorro JG, Cunha JM |title=Diabetic neuropathic pain: Physiopathology and treatment |journal=World J Diabetes |volume=6 |issue=3 |pages=432–44 |date=April 2015 |pmid=25897354 |doi=10.4239/wjd.v6.i3.432 |url=}}</ref> | ||
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* Diabetes mellitus | * [[Diabetes mellitus]] | ||
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* Symmetric sensorimotor distal polyneuropathy | * Symmetric sensorimotor distal polyneuropathy | ||
* Asymmetric proximal neuropathy | * Asymmetric proximal neuropathy | ||
* 3rd nerve palsy | * [[Oculomotor nerve palsy|3rd nerve palsy]] | ||
* Carpel tunnel syndrome | * [[Carpal tunnel syndrome|Carpel tunnel syndrome]] | ||
* Autonomic neuropathy | * [[Autonomic neuropathy]] | ||
* "Glove and stocking" type pain | * "Glove and stocking" type pain | ||
* Muscle wasting | * [[Muscle wasting]] | ||
* Hammer toes | * [[Hammer toe|Hammer toes]] | ||
* Polyuria | * [[Polyuria]] | ||
* Polydipsia | * [[Polydipsia]] | ||
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* Uncontrolled hyperglycemia | * Uncontrolled [[hyperglycemia]] | ||
* Slowed nerve conduction | * Slowed [[Nerve conduction study|nerve conduction]] | ||
* Small fiber dysfunction | * [[Small fiber peripheral neuropathy|Small fiber dysfunction]] | ||
* Monofilament testing | * [[Monofilament|Monofilament testing]] | ||
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* Fasting blood sugar level greater than equal to 126 mg/dl on 2 separate | * [[Fasting blood sugar|Fasting blood sugar level]] greater than equal to 126 mg/dl on 2 separate occasions<ref name="pmid20042775">{{cite journal |vauthors= |title=Diagnosis and classification of diabetes mellitus |journal=Diabetes Care |volume=33 Suppl 1 |issue= |pages=S62–9 |date=January 2010 |pmid=20042775 |doi=10.2337/dc10-S062 |url=}}</ref> | ||
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* Anti-diabetic therapy | * [[Diabetes mellitus medical therapy|Anti-diabetic therapy]] | ||
* Gabapentin | * [[Gabapentin]] | ||
* Carbamazepine | * [[Carbamazepine]] | ||
* Foot care | * [[Foot care]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Vitamin Deficiencies (Axonal Pathology)'''<ref name="pmid28129784">{{cite journal |vauthors=Ekabe CJ, Kehbila J, Abanda MH, Kadia BM, Sama CB, Monekosso GL |title=Vitamin B12 deficiency neuropathy; a rare diagnosis in young adults: a case report |journal=BMC Res Notes |volume=10 |issue=1 |pages=72 |date=January 2017 |pmid=28129784 |doi=10.1186/s13104-017-2393-3 |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Vitamin deficiencies|Vitamin Deficiencies]] (Axonal Pathology)'''<ref name="pmid28129784">{{cite journal |vauthors=Ekabe CJ, Kehbila J, Abanda MH, Kadia BM, Sama CB, Monekosso GL |title=Vitamin B12 deficiency neuropathy; a rare diagnosis in young adults: a case report |journal=BMC Res Notes |volume=10 |issue=1 |pages=72 |date=January 2017 |pmid=28129784 |doi=10.1186/s13104-017-2393-3 |url=}}</ref> | ||
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* Vitamin B12 deficiency (Decreased S-adenosyl methionine)<ref name="pmid2738712">{{cite journal |vauthors=Doi T, Kawata T, Tadano N, Iijima T, Maekawa A |title=Effect of vitamin B12 deficiency on S-adenosylmethionine metabolism in rats |journal=J. Nutr. Sci. Vitaminol. |volume=35 |issue=1 |pages=1–9 |date=February 1989 |pmid=2738712 |doi= |url=}}</ref> | * [[Vitamin B12 deficiency]] (Decreased [[S-Adenosyl methionine|S-adenosyl methionine]])<ref name="pmid2738712">{{cite journal |vauthors=Doi T, Kawata T, Tadano N, Iijima T, Maekawa A |title=Effect of vitamin B12 deficiency on S-adenosylmethionine metabolism in rats |journal=J. Nutr. Sci. Vitaminol. |volume=35 |issue=1 |pages=1–9 |date=February 1989 |pmid=2738712 |doi= |url=}}</ref> | ||
* Vitamin B1 deficiency | * [[Thiamine deficiency|Vitamin B1 deficiency]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Primarily sensory | * Primarily [[sensory]] deficits | ||
* Vibration and proprioception affected | * Vibration and [[proprioception]] affected | ||
* Gait abnormalities | * [[Gait abnormality|Gait abnormalities]] | ||
* Cognitive impairment | * [[Cognitive impairment]] | ||
* Irritability | * [[Irritability]] | ||
* Glossitis | * [[Glossitis]] | ||
* | * | ||
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* Anemia ( | * [[Anemia]] ([[Megaloblastic Anemias|megaloblastic]] in case of [[Vitamin B12 deficiency|B12 deficiency]])<ref name="pmid23262189">{{cite journal |vauthors=Berg RL, Shaw GR |title=Laboratory evaluation for vitamin B12 deficiency: the case for cascade testing |journal=Clin Med Res |volume=11 |issue=1 |pages=7–15 |date=February 2013 |pmid=23262189 |doi=10.3121/cmr.2012.1112 |url=}}</ref> | ||
* Decreased serum Vitamin B12 levels (< 200 pg/ml) | * Decreased [[serum]] [[Vitamin B12]] levels (< 200 pg/ml) | ||
* Elevated | * [[Methylmalonic acidemia|Elevated methylmalonic acid]] | ||
* | * | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Serum Vitamin B12 levels<ref name="pmid2339684">{{cite journal |vauthors=Lindenbaum J, Savage DG, Stabler SP, Allen RH |title=Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations |journal=Am. J. Hematol. |volume=34 |issue=2 |pages=99–107 |date=June 1990 |pmid=2339684 |doi= |url=}}</ref> | * [[Serum]] [[Vitamin B12]] levels<ref name="pmid2339684">{{cite journal |vauthors=Lindenbaum J, Savage DG, Stabler SP, Allen RH |title=Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations |journal=Am. J. Hematol. |volume=34 |issue=2 |pages=99–107 |date=June 1990 |pmid=2339684 |doi= |url=}}</ref> | ||
* | * [[Methylmalonic acid|Methylmalonic acid levels]] | ||
* Intrinsic factor antibodies<ref name="pmid232621892">{{cite journal |vauthors=Berg RL, Shaw GR |title=Laboratory evaluation for vitamin B12 deficiency: the case for cascade testing |journal=Clin Med Res |volume=11 |issue=1 |pages=7–15 |date=February 2013 |pmid=23262189 |pmc=3573090 |doi=10.3121/cmr.2012.1112 |url=}}</ref> | * [[Intrinsic factor|Intrinsic factor antibodies]]<ref name="pmid232621892">{{cite journal |vauthors=Berg RL, Shaw GR |title=Laboratory evaluation for vitamin B12 deficiency: the case for cascade testing |journal=Clin Med Res |volume=11 |issue=1 |pages=7–15 |date=February 2013 |pmid=23262189 |pmc=3573090 |doi=10.3121/cmr.2012.1112 |url=}}</ref> | ||
* | * | ||
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* Vitamin B12 supplement (parenteral)<ref name="pmid12086562">{{cite journal |vauthors=Lane LA, Rojas-Fernandez C |title=Treatment of vitamin b(12)-deficiency anemia: oral versus parenteral therapy |journal=Ann Pharmacother |volume=36 |issue=7-8 |pages=1268–72 |date=2002 |pmid=12086562 |doi=10.1345/aph.1A122 |url=}}</ref> | * [[Vitamin B12]] supplement ([[parenteral]])<ref name="pmid12086562">{{cite journal |vauthors=Lane LA, Rojas-Fernandez C |title=Treatment of vitamin b(12)-deficiency anemia: oral versus parenteral therapy |journal=Ann Pharmacother |volume=36 |issue=7-8 |pages=1268–72 |date=2002 |pmid=12086562 |doi=10.1345/aph.1A122 |url=}}</ref> | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Guillain-Barre Syndrome (Demyelinating)'''<ref name="pmid117249122">{{cite journal |vauthors=Winer JB |title=Guillain Barré syndrome |journal=MP, Mol. Pathol. |volume=54 |issue=6 |pages=381–5 |date=December 2001 |pmid=11724912 |pmc=1187127 |doi= |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Guillain-Barré syndrome|Guillain-Barre Syndrome]] (Demyelinating)'''<ref name="pmid117249122">{{cite journal |vauthors=Winer JB |title=Guillain Barré syndrome |journal=MP, Mol. Pathol. |volume=54 |issue=6 |pages=381–5 |date=December 2001 |pmid=11724912 |pmc=1187127 |doi= |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Anti-ganglioside and anti-myelin antibodies<ref name="pmid7486873">{{cite journal |vauthors=Rees JH, Gregson NA, Hughes RA |title=Anti-ganglioside GM1 antibodies in Guillain-Barré syndrome and their relationship to Campylobacter jejuni infection |journal=Ann. Neurol. |volume=38 |issue=5 |pages=809–16 |date=November 1995 |pmid=7486873 |doi=10.1002/ana.410380516 |url=}}</ref> | * [[Anti-ganglioside antibodies|Anti-ganglioside]] and anti-[[myelin]] antibodies<ref name="pmid7486873">{{cite journal |vauthors=Rees JH, Gregson NA, Hughes RA |title=Anti-ganglioside GM1 antibodies in Guillain-Barré syndrome and their relationship to Campylobacter jejuni infection |journal=Ann. Neurol. |volume=38 |issue=5 |pages=809–16 |date=November 1995 |pmid=7486873 |doi=10.1002/ana.410380516 |url=}}</ref> | ||
* Viral infections:<ref name="pmid3404161">{{cite journal |vauthors=Winer JB, Hughes RA, Anderson MJ, Jones DM, Kangro H, Watkins RP |title=A prospective study of acute idiopathic neuropathy. II. Antecedent events |journal=J. Neurol. Neurosurg. Psychiatry |volume=51 |issue=5 |pages=613–8 |date=May 1988 |pmid=3404161 |pmc=1033063 |doi= |url=}}</ref> | * [[Viral]] infections:<ref name="pmid3404161">{{cite journal |vauthors=Winer JB, Hughes RA, Anderson MJ, Jones DM, Kangro H, Watkins RP |title=A prospective study of acute idiopathic neuropathy. II. Antecedent events |journal=J. Neurol. Neurosurg. Psychiatry |volume=51 |issue=5 |pages=613–8 |date=May 1988 |pmid=3404161 |pmc=1033063 |doi= |url=}}</ref> | ||
** Epstein Barr virus | ** [[Epstein Barr virus]] | ||
** HIV | ** [[Human Immunodeficiency Virus (HIV)|HIV]] | ||
** Cytomegalovirus | ** [[Cytomegalovirus]] | ||
** Varicella Zoster virus | ** [[Varicella Zoster Virus|Varicella Zoster virus]] | ||
* Bacterial infections:<ref name="pmid16969154">{{cite journal |vauthors=Yuki N, Koga M |title=Bacterial infections in Guillain-Barré and Fisher syndromes |journal=Curr. Opin. Neurol. |volume=19 |issue=5 |pages=451–7 |date=October 2006 |pmid=16969154 |doi=10.1097/01.wco.0000245367.36576.e9 |url=}}</ref> | * [[Bacterial]] infections:<ref name="pmid16969154">{{cite journal |vauthors=Yuki N, Koga M |title=Bacterial infections in Guillain-Barré and Fisher syndromes |journal=Curr. Opin. Neurol. |volume=19 |issue=5 |pages=451–7 |date=October 2006 |pmid=16969154 |doi=10.1097/01.wco.0000245367.36576.e9 |url=}}</ref> | ||
** Campylobacter infection | ** [[Campylobacter]] infection | ||
** Mycoplasma pneumoniae | ** [[Mycoplasma pneumoniae]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Rapid onset and quick progression | * Rapid onset and quick progression | ||
* Progression stops after 2-3 weeks | * Progression stops after 2-3 weeks | ||
* Bilateral ascending paraesthesias and paralysis (generalized) | * Bilateral ascending [[Paraesthesia|paraesthesias]] and [[paralysis]] (generalized) | ||
* Weakness | * [[Muscle weakness|Weakness]] | ||
* Ataxia | * [[Ataxia]] | ||
* Areflexia | * [[Areflexia]] | ||
* No fever | * No fever | ||
* 4 sub-types: | * 4 sub-types: | ||
**Acute inflammatory demyelinating polyneuropathy | **[[Acute inflammatory demyelinating polyneuropathy]] | ||
**Acute motor axonal neuropathy | **[[Acute motor axonal neuropathy]] | ||
**Acute motor and sensory axonal neuropathy | **Acute motor and sensory axonal neuropathy | ||
**Miller Fisher syndrome | **[[Miller Fisher syndrome]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Delayed F waves<ref name="pmid666277">{{cite journal |vauthors=Kimura J |title=Proximal versus distal slowing of motor nerve conduction velocity in the Guillain-Barré syndrome |journal=Ann. Neurol. |volume=3 |issue=4 |pages=344–50 |date=April 1978 |pmid=666277 |doi=10.1002/ana.410030412 |url=}}</ref> | * Delayed F waves<ref name="pmid666277">{{cite journal |vauthors=Kimura J |title=Proximal versus distal slowing of motor nerve conduction velocity in the Guillain-Barré syndrome |journal=Ann. Neurol. |volume=3 |issue=4 |pages=344–50 |date=April 1978 |pmid=666277 |doi=10.1002/ana.410030412 |url=}}</ref> | ||
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* Clinical diagnostic criteria (progressive weakness of more than two limbs, areflexia, and progression for no more than four weeks)<ref name="pmid11724912">{{cite journal |vauthors=Winer JB |title=Guillain Barré syndrome |journal=MP, Mol. Pathol. |volume=54 |issue=6 |pages=381–5 |date=December 2001 |pmid=11724912 |pmc=1187127 |doi= |url=}}</ref> | * Clinical diagnostic criteria (progressive weakness of more than two [[limbs]], [[areflexia]], and progression for no more than four weeks)<ref name="pmid11724912">{{cite journal |vauthors=Winer JB |title=Guillain Barré syndrome |journal=MP, Mol. Pathol. |volume=54 |issue=6 |pages=381–5 |date=December 2001 |pmid=11724912 |pmc=1187127 |doi= |url=}}</ref> | ||
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* Intravenous immunoglobulins<ref name="pmid9014908">{{cite journal |vauthors= |title=Randomised trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain-Barré syndrome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group |journal=Lancet |volume=349 |issue=9047 |pages=225–30 |date=January 1997 |pmid=9014908 |doi= |url=}}</ref> | * [[Intravenous]] [[immunoglobulins]]<ref name="pmid9014908">{{cite journal |vauthors= |title=Randomised trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain-Barré syndrome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group |journal=Lancet |volume=349 |issue=9047 |pages=225–30 |date=January 1997 |pmid=9014908 |doi= |url=}}</ref> | ||
* Plasma exchange<ref name="pmid4022342">{{cite journal |vauthors= |title=Plasmapheresis and acute Guillain-Barré syndrome. The Guillain-Barré syndrome Study Group |journal=Neurology |volume=35 |issue=8 |pages=1096–104 |date=August 1985 |pmid=4022342 |doi= |url=}}</ref> | * [[Plasma]] exchange<ref name="pmid4022342">{{cite journal |vauthors= |title=Plasmapheresis and acute Guillain-Barré syndrome. The Guillain-Barré syndrome Study Group |journal=Neurology |volume=35 |issue=8 |pages=1096–104 |date=August 1985 |pmid=4022342 |doi= |url=}}</ref> | ||
* Respiratory support | * [[Mechanical ventilation|Respiratory support]] | ||
* DVT/PE prevention | * [[DVT]]/[[PE]] [[prevention]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) (Mixed axonal and demyelinatiing)'''<ref name="urlChronic Inflammatory Demyelinating Polyradiculoneuropathy: Clinical Characteristics, Course, and Recommendations for Diagnostic Criteria | JAMA Neurology | JAMA Network">{{cite web |url=https://jamanetwork.com/journals/jamaneurology/article-abstract/589258 |title=Chronic Inflammatory Demyelinating Polyradiculoneuropathy: Clinical Characteristics, Course, and Recommendations for Diagnostic Criteria | JAMA Neurology | JAMA Network |format= |work= |accessdate=}}</ref><ref name="urlonlinelibrary.wiley.com2">{{cite web |url=https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1468-1331.2009.02930.x |title=onlinelibrary.wiley.com |format= |work= |accessdate=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Chronic inflammatory demyelinating polyneuropathy|Chronic Inflammatory Demyelinating Polyneuropathy]] (CIDP) (Mixed axonal and demyelinatiing)'''<ref name="urlChronic Inflammatory Demyelinating Polyradiculoneuropathy: Clinical Characteristics, Course, and Recommendations for Diagnostic Criteria | JAMA Neurology | JAMA Network">{{cite web |url=https://jamanetwork.com/journals/jamaneurology/article-abstract/589258 |title=Chronic Inflammatory Demyelinating Polyradiculoneuropathy: Clinical Characteristics, Course, and Recommendations for Diagnostic Criteria | JAMA Neurology | JAMA Network |format= |work= |accessdate=}}</ref><ref name="urlonlinelibrary.wiley.com2">{{cite web |url=https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1468-1331.2009.02930.x |title=onlinelibrary.wiley.com |format= |work= |accessdate=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Abnormal immune (both IgG based humoral and T-Cell mediated) response to unknown antigen (possible culprits include myelin proteins P0, P2 and PMP22)<ref name="pmid2440998">{{cite journal |vauthors=Milner P, Lovelidge CA, Taylor WA, Hughes RA |title=P0 myelin protein produces experimental allergic neuritis in Lewis rats |journal=J. Neurol. Sci. |volume=79 |issue=3 |pages=275–85 |date=July 1987 |pmid=2440998 |doi= |url=}}</ref><ref name="pmid10713353">{{cite journal |vauthors=Gabriel CM, Gregson NA, Hughes RA |title=Anti-PMP22 antibodies in patients with inflammatory neuropathy |journal=J. Neuroimmunol. |volume=104 |issue=2 |pages=139–46 |date=May 2000 |pmid=10713353 |doi= |url=}}</ref><ref name="pmid10025777">{{cite journal |vauthors=Bouchard C, Lacroix C, Planté V, Adams D, Chedru F, Guglielmi JM, Said G |title=Clinicopathologic findings and prognosis of chronic inflammatory demyelinating polyneuropathy |journal=Neurology |volume=52 |issue=3 |pages=498–503 |date=February 1999 |pmid=10025777 |doi= |url=}}</ref> | * Abnormal [[immune response]] (both [[Immunoglobulin G|IgG]] based [[Humoral immunity|humoral]] and [[Cell mediated immunity|T-Cell mediated]]) response to unknown [[antigen]] (possible culprits include [[myelin]] [[proteins]] P0, P2 and PMP22)<ref name="pmid2440998">{{cite journal |vauthors=Milner P, Lovelidge CA, Taylor WA, Hughes RA |title=P0 myelin protein produces experimental allergic neuritis in Lewis rats |journal=J. Neurol. Sci. |volume=79 |issue=3 |pages=275–85 |date=July 1987 |pmid=2440998 |doi= |url=}}</ref><ref name="pmid10713353">{{cite journal |vauthors=Gabriel CM, Gregson NA, Hughes RA |title=Anti-PMP22 antibodies in patients with inflammatory neuropathy |journal=J. Neuroimmunol. |volume=104 |issue=2 |pages=139–46 |date=May 2000 |pmid=10713353 |doi= |url=}}</ref><ref name="pmid10025777">{{cite journal |vauthors=Bouchard C, Lacroix C, Planté V, Adams D, Chedru F, Guglielmi JM, Said G |title=Clinicopathologic findings and prognosis of chronic inflammatory demyelinating polyneuropathy |journal=Neurology |volume=52 |issue=3 |pages=498–503 |date=February 1999 |pmid=10025777 |doi= |url=}}</ref> | ||
* | * | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Slow onset and gradual progression | * Slow onset and gradual progression | ||
* Relapsing and remitting course | * [[Relapse|Relapsing]] and remitting course | ||
* Symmetrical proximal and distal motor and sensory weakness (legs>arms) | * Symmetrical [[Proximal muscle weakness|proximal]] and [[Distal muscle weakness|distal motor]] and [[Sensory system|sensory weakness]] (legs>arms) | ||
* Foot drop | * [[Foot drop]] | ||
* Numbness, tingling and pain | * [[Numbness]], [[tingling]] and [[pain]] | ||
* Areflexia | * [[Areflexia]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Elevated CSF protein (oligoclonal bands with normal WBCs)<ref name="pmid11558784">{{cite journal |vauthors=Yan WX, Archelos JJ, Hartung HP, Pollard JD |title=P0 protein is a target antigen in chronic inflammatory demyelinating polyradiculoneuropathy |journal=Ann. Neurol. |volume=50 |issue=3 |pages=286–92 |date=September 2001 |pmid=11558784 |doi= |url=}}</ref> | * Elevated [[CSF]] [[protein]] ([[oligoclonal bands]] with normal [[White blood cells|WBCs]])<ref name="pmid11558784">{{cite journal |vauthors=Yan WX, Archelos JJ, Hartung HP, Pollard JD |title=P0 protein is a target antigen in chronic inflammatory demyelinating polyradiculoneuropathy |journal=Ann. Neurol. |volume=50 |issue=3 |pages=286–92 |date=September 2001 |pmid=11558784 |doi= |url=}}</ref> | ||
* Slowed motor nerve conduction velocities<ref name="pmid2757528">{{cite journal |vauthors=Barohn RJ, Kissel JT, Warmolts JR, Mendell JR |title=Chronic inflammatory demyelinating polyradiculoneuropathy. Clinical characteristics, course, and recommendations for diagnostic criteria |journal=Arch. Neurol. |volume=46 |issue=8 |pages=878–84 |date=August 1989 |pmid=2757528 |doi= |url=}}</ref> | * Slowed [[Nerve conduction study|motor nerve conduction velocities]]<ref name="pmid2757528">{{cite journal |vauthors=Barohn RJ, Kissel JT, Warmolts JR, Mendell JR |title=Chronic inflammatory demyelinating polyradiculoneuropathy. Clinical characteristics, course, and recommendations for diagnostic criteria |journal=Arch. Neurol. |volume=46 |issue=8 |pages=878–84 |date=August 1989 |pmid=2757528 |doi= |url=}}</ref> | ||
* Prolonged distal motor latencies (period between F wave and initial stimulation) | * Prolonged distal [[Motor skill|motor]] latencies (period between F wave and initial stimulation) | ||
* Delayed F wave latencies (recorded from the feet, hence called "F" waves)<ref name="pmid27575282">{{cite journal |vauthors=Barohn RJ, Kissel JT, Warmolts JR, Mendell JR |title=Chronic inflammatory demyelinating polyradiculoneuropathy. Clinical characteristics, course, and recommendations for diagnostic criteria |journal=Arch. Neurol. |volume=46 |issue=8 |pages=878–84 |date=August 1989 |pmid=2757528 |doi= |url=}}</ref> | * Delayed F wave latencies (recorded from the [[feet]], hence called "F" waves)<ref name="pmid27575282">{{cite journal |vauthors=Barohn RJ, Kissel JT, Warmolts JR, Mendell JR |title=Chronic inflammatory demyelinating polyradiculoneuropathy. Clinical characteristics, course, and recommendations for diagnostic criteria |journal=Arch. Neurol. |volume=46 |issue=8 |pages=878–84 |date=August 1989 |pmid=2757528 |doi= |url=}}</ref> | ||
* MRI contrast enhancement and enlargement of T2 spinal segments<ref name="pmid23564314">{{cite journal |vauthors=Dimachkie MM, Barohn RJ |title=Chronic inflammatory demyelinating polyneuropathy |journal=Curr Treat Options Neurol |volume=15 |issue=3 |pages=350–66 |date=June 2013 |pmid=23564314 |pmc=3987657 |doi=10.1007/s11940-013-0229-6 |url=}}</ref> | * [[MRI]] contrast enhancement and enlargement of [[Vertebra|T2]] [[spinal segments]]<ref name="pmid23564314">{{cite journal |vauthors=Dimachkie MM, Barohn RJ |title=Chronic inflammatory demyelinating polyneuropathy |journal=Curr Treat Options Neurol |volume=15 |issue=3 |pages=350–66 |date=June 2013 |pmid=23564314 |pmc=3987657 |doi=10.1007/s11940-013-0229-6 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* EFNS/PNS criteria<ref name="urlonlinelibrary.wiley.com">{{cite web |url=https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1468-1331.2009.02930.x |title=onlinelibrary.wiley.com |format= |work= |accessdate=}}</ref> | * EFNS/PNS criteria<ref name="urlonlinelibrary.wiley.com">{{cite web |url=https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1468-1331.2009.02930.x |title=onlinelibrary.wiley.com |format= |work= |accessdate=}}</ref> | ||
* Koski criteria<ref name="pmid19091330">{{cite journal |vauthors=Koski CL, Baumgarten M, Magder LS, Barohn RJ, Goldstein J, Graves M, Gorson K, Hahn AF, Hughes RA, Katz J, Lewis RA, Parry GJ, van Doorn P, Cornblath DR |title=Derivation and validation of diagnostic criteria for chronic inflammatory demyelinating polyneuropathy |journal=J. Neurol. Sci. |volume=277 |issue=1-2 |pages=1–8 |date=February 2009 |pmid=19091330 |doi=10.1016/j.jns.2008.11.015 |url=}}</ref> | * Koski criteria<ref name="pmid19091330">{{cite journal |vauthors=Koski CL, Baumgarten M, Magder LS, Barohn RJ, Goldstein J, Graves M, Gorson K, Hahn AF, Hughes RA, Katz J, Lewis RA, Parry GJ, van Doorn P, Cornblath DR |title=Derivation and validation of diagnostic criteria for chronic inflammatory demyelinating polyneuropathy |journal=J. Neurol. Sci. |volume=277 |issue=1-2 |pages=1–8 |date=February 2009 |pmid=19091330 |doi=10.1016/j.jns.2008.11.015 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Corticosteroids | * [[Corticosteroids]] | ||
* Intravenous immunoglobulin (IVIG) | * [[Intravenous immunoglobulin]] ([[IVIG]]) | ||
* | * [[Immunosupressive drug|Immunosupressants]] ([[Alemtuzumab|Alemtuzemab]] [[Azathioprine]] [[Cyclophosphamide]] [[Cyclosporine|Cyclosporin]] [[Etanercept]] [[Interferon-alpha]]) | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Multifocal Motor Neuropathy'''<ref name="RobbinsLawson2018">{{cite journal|last1=Robbins|first1=Nathaniel M|last2=Lawson|first2=Victoria|title=The Potential Misdiagnosis of Multifocal Motor Neuropathy as Amyotrophic Lateral Sclerosis—A Case Series|journal=US Neurology|volume=14|issue=2|year=2018|pages=102|issn=1758-4000|doi=10.17925/USN.2018.14.2.102}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Multifocal motor neuropathy|Multifocal Motor Neuropathy]]'''<ref name="RobbinsLawson2018">{{cite journal|last1=Robbins|first1=Nathaniel M|last2=Lawson|first2=Victoria|title=The Potential Misdiagnosis of Multifocal Motor Neuropathy as Amyotrophic Lateral Sclerosis—A Case Series|journal=US Neurology|volume=14|issue=2|year=2018|pages=102|issn=1758-4000|doi=10.17925/USN.2018.14.2.102}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Abnormal immune response (Anti ganglioside GM-1 IgM antibodies) | * [[Immune response|Abnormal immune response]] ([[Anti-ganglioside antibodies|Anti ganglioside]] [[Anti-ganglioside antibodies|GM-1]] [[IgM]] [[antibodies]]) | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Progressive, asymmetric, distal and upper limb predominant weakness | * Progressive, asymmetric, distal and upper [[Limb (anatomy)|limb]] predominant weakness | ||
* No significant sensory abnormalities | * No significant [[sensory]] abnormalities | ||
* Areflexia | * [[Areflexia]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Elevated CSF protein | * Elevated [[CSF]] [[protein]] | ||
* | * | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Clinical criteria (EFNS/PNS):<ref name="pmid21199100">{{cite journal |vauthors= |title=European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society--first revision |journal=J. Peripher. Nerv. Syst. |volume=15 |issue=4 |pages=295–301 |date=December 2010 |pmid=21199100 |doi=10.1111/j.1529-8027.2010.00290.x |url=}}</ref> | * Clinical criteria (EFNS/PNS):<ref name="pmid21199100">{{cite journal |vauthors= |title=European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of multifocal motor neuropathy. Report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society--first revision |journal=J. Peripher. Nerv. Syst. |volume=15 |issue=4 |pages=295–301 |date=December 2010 |pmid=21199100 |doi=10.1111/j.1529-8027.2010.00290.x |url=}}</ref> | ||
** Slowly progressive or | ** Slowly progressive or step-wise progressive, focal, asymmetric [[limb]] weakness; i.e., [[Motor skill|motor]] involvement in the [[motor nerve]] distribution of at least two nerves for > 1 month. | ||
** No objective sensory abnormalities except for minor vibration sense abnormalities in the lower limbs | ** No objective [[Sensory system|sensory]] abnormalities except for minor vibration sense abnormalities in the [[lower limbs]] | ||
* | * | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Intravenous | * [[Intravenous immunoglobulin|Intravenous immunoglobulins]] | ||
* Cyclophosphamide | * [[Cyclophosphamide]] | ||
* Rituximab | * [[Rituximab]] | ||
|- | |- | ||
| colspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|'''Organ System Involvement'''}} | | colspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|'''Organ System Involvement'''}} | ||
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|- | |- | ||
| colspan="2" rowspan="7" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''''O = Organomegaly (Hepatosplenomegaly and Lymphadenopathy)''''' | | colspan="2" rowspan="7" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''''O = Organomegaly (Hepatosplenomegaly and Lymphadenopathy)''''' | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Malaria'''<ref name="pmid22708041">{{cite journal |vauthors=Bartoloni A, Zammarchi L |title=Clinical aspects of uncomplicated and severe malaria |journal=Mediterr J Hematol Infect Dis |volume=4 |issue=1 |pages=e2012026 |date=2012 |pmid=22708041 |doi=10.4084/MJHID.2012.026 |url=}}</ref><ref name="pmid19488414">{{cite journal |vauthors=Tangpukdee N, Duangdee C, Wilairatana P, Krudsood S |title=Malaria diagnosis: a brief review |journal=Korean J. Parasitol. |volume=47 |issue=2 |pages=93–102 |date=June 2009 |pmid=19488414 |doi=10.3347/kjp.2009.47.2.93 |url=}}</ref><ref name="pmid8703186">{{cite journal |vauthors=White NJ |title=The treatment of malaria |journal=N. Engl. J. Med. |volume=335 |issue=11 |pages=800–6 |date=September 1996 |pmid=8703186 |doi=10.1056/NEJM199609123351107 |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Malaria]]'''<ref name="pmid22708041">{{cite journal |vauthors=Bartoloni A, Zammarchi L |title=Clinical aspects of uncomplicated and severe malaria |journal=Mediterr J Hematol Infect Dis |volume=4 |issue=1 |pages=e2012026 |date=2012 |pmid=22708041 |doi=10.4084/MJHID.2012.026 |url=}}</ref><ref name="pmid19488414">{{cite journal |vauthors=Tangpukdee N, Duangdee C, Wilairatana P, Krudsood S |title=Malaria diagnosis: a brief review |journal=Korean J. Parasitol. |volume=47 |issue=2 |pages=93–102 |date=June 2009 |pmid=19488414 |doi=10.3347/kjp.2009.47.2.93 |url=}}</ref><ref name="pmid8703186">{{cite journal |vauthors=White NJ |title=The treatment of malaria |journal=N. Engl. J. Med. |volume=335 |issue=11 |pages=800–6 |date=September 1996 |pmid=8703186 |doi=10.1056/NEJM199609123351107 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Plasmodium falciparum | * [[Plasmodium falciparum]] | ||
* P. ovale | * [[Plasmodium ovale|P. ovale]] | ||
* P. malariae | * [[P. malariae]] | ||
* P. knowlesi | * [[Plasmodium knowlesi|P. knowlesi]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Tertian (vivax, ovale, falciparum), quartan (malariae), quotidian fever (knowlesi) | * Tertian ([[Plasmodium vivax|vivax]], [[Plasmodium ovale|ovale]], [[Plasmodium falciparum|falciparum]]), quartan (malariae), quotidian fever ([[Plasmodium knowlesi|knowlesi]]) | ||
* Vector is female Anopheles mosquito | * [[Vector]] is female [[Anopheles]] mosquito | ||
* Hepatosplenomegaly | * [[Hepatosplenomegaly]] | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
* Jaundice | * [[Jaundice]] | ||
* Icterus | * [[Icterus (medicine)|Icterus]] | ||
* Tachycardia | * [[Tachycardia]] | ||
* Tachypnea | * [[Tachypnea]] | ||
* Productive cough | * [[Productive cough]] | ||
* | * [[Hematuria]] | ||
* Altered mental status | * [[Altered mental status]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Microcytic anemia | * [[Microcytic anemia]] | ||
* Thick and thin blood films (Giemsa staining) | * [[Malaria differential diagnosis|Thick and thin blood films]] ([[Giemsa stain|Giemsa staining]]) | ||
* Rapid diagnostic test (antigen detection | * Rapid diagnostic test ([[antigen]] detection | ||
* Polymerase chain reaction (PCR) | * [[Polymerase chain reaction]] ([[Polymerase chain reaction|PCR]]) | ||
* Enzyme linked immunosorbent assay (ELISA) | * [[Enzyme linked immunosorbent assay (ELISA)|Enzyme linked immunosorbent assay]] ([[Enzyme linked immunosorbent assay (ELISA)|ELISA]]) | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Thick and thin films | * [[Malaria differential diagnosis|Thick and thin films]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Non-falciparum species: | * Non-[[Plasmodium falciparum|falciparum]] species: | ||
** | ** [[Chloroquine]] (in susceptible) | ||
** Artemisinin plus mefloquin or lumefantrine (in chloroquine resistant) | ** [[Artemisinin]] plus [[Mefloquine|mefloquin]] or [[lumefantrine]] (in [[chloroquine]] resistant) | ||
* Falciparum species: | * [[Plasmodium falciparum|Falciparum]] species: | ||
** Chloroquine (in susceptible) | ** [[Chloroquine]] (in susceptible) | ||
** Artemether plus lumefantrine (in chloroquin resistant) OR | ** [[Artemether]] plus [[lumefantrine]] (in [[Chloroquine|chloroquin]] resistant) OR | ||
** Artesunate plus mefloquin OR | ** [[Artesunate]] plus [[Mefloquine|mefloquin]] OR | ||
** Artesunate plus sulfadoxine-pyrimethamine | ** [[Artesunate]] plus [[Sulfadoxine|sulfadoxine-pyrimethamine]] | ||
** Atovaquone plus proguanil | ** [[Atovaquone-Proguanil|Atovaquone plus proguanil]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Kala-azar'''<ref name="pmid10798038">{{cite journal |vauthors=Aggarwal P, Handa R, Singh S, Wali JP |title=Kala-azar--new developments in diagnosis and treatment |journal=Indian J Pediatr |volume=66 |issue=1 |pages=63–71 |date=1999 |pmid=10798038 |doi= |url=}}</ref><ref name="pmid28649370">{{cite journal |vauthors=Torres-Guerrero E, Quintanilla-Cedillo MR, Ruiz-Esmenjaud J, Arenas R |title=Leishmaniasis: a review |journal=F1000Res |volume=6 |issue= |pages=750 |date=2017 |pmid=28649370 |doi=10.12688/f1000research.11120.1 |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Kala-azar]]'''<ref name="pmid10798038">{{cite journal |vauthors=Aggarwal P, Handa R, Singh S, Wali JP |title=Kala-azar--new developments in diagnosis and treatment |journal=Indian J Pediatr |volume=66 |issue=1 |pages=63–71 |date=1999 |pmid=10798038 |doi= |url=}}</ref><ref name="pmid28649370">{{cite journal |vauthors=Torres-Guerrero E, Quintanilla-Cedillo MR, Ruiz-Esmenjaud J, Arenas R |title=Leishmaniasis: a review |journal=F1000Res |volume=6 |issue= |pages=750 |date=2017 |pmid=28649370 |doi=10.12688/f1000research.11120.1 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Leshmania donovani | * [[Leishmaniasis|Leshmania donovani]] | ||
* L. infantum | * L. infantum | ||
* L. chagasi | * L. chagasi | ||
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* | * | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Fever | * [[Fever]] | ||
* Vector is sandfly | * Vector is [[sandfly]] | ||
* Hepatosplenomegaly | * [[Hepatosplenomegaly]] | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
* Hyperpigmentation | * [[Hyperpigmentation]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Anemia | * [[Anemia]] | ||
* Direct | * [[Direct agglutination test]] (DAT) | ||
* rk39 dipstick | * rk39 dipstick | ||
* ELISA | * [[Enzyme linked immunosorbent assay (ELISA)|ELISA]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Splenic aspiration | * [[Splenic]] aspiration | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Liposomal amphotericin B | * [[Liposomal amphotericin B]] | ||
* Sodium stibogluconate | * [[Sodium stibogluconate]] | ||
* Pentamidine | * [[Pentamidine]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Infective Hepatitis'''<ref name="pmid19399811">{{cite journal |vauthors=Liang TJ |title=Hepatitis B: the virus and disease |journal=Hepatology |volume=49 |issue=5 Suppl |pages=S13–21 |date=May 2009 |pmid=19399811 |pmc=2809016 |doi=10.1002/hep.22881 |url=}}</ref><ref name="pmid26052383">{{cite journal |vauthors=Li HC, Lo SY |title=Hepatitis C virus: Virology, diagnosis and treatment |journal=World J Hepatol |volume=7 |issue=10 |pages=1377–89 |date=June 2015 |pmid=26052383 |pmc=4450201 |doi=10.4254/wjh.v7.i10.1377 |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Hepatitis|Infective Hepatitis]]'''<ref name="pmid19399811">{{cite journal |vauthors=Liang TJ |title=Hepatitis B: the virus and disease |journal=Hepatology |volume=49 |issue=5 Suppl |pages=S13–21 |date=May 2009 |pmid=19399811 |pmc=2809016 |doi=10.1002/hep.22881 |url=}}</ref><ref name="pmid26052383">{{cite journal |vauthors=Li HC, Lo SY |title=Hepatitis C virus: Virology, diagnosis and treatment |journal=World J Hepatol |volume=7 |issue=10 |pages=1377–89 |date=June 2015 |pmid=26052383 |pmc=4450201 |doi=10.4254/wjh.v7.i10.1377 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Hepatitis A virus (HAV) | * [[Hepatitis A virus|Hepatitis A virus (HAV)]] | ||
* HBV | * [[HBV]] | ||
* HCV | * [[Hepatitis C|HCV]] | ||
* HDV (co-infection with HBV) | * [[Hepatitis D|HDV]] (co-infection with [[HBV]]) | ||
* HEV | * [[Hepatitis E|HEV]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Fever | * [[Fever]] | ||
* Transmitted via fecal-oral route (HAV, HBV, HDV, HEV), infected sera (HCV), sexual contact with infected individuals | * Transmitted via [[fecal-oral route]] ([[Hepatitis A|HAV]], [[Hepatitis B virus|HBV]], [[HDV]], [[HEV]]), infected sera ([[HCV]]), [[sexual contact]] with infected individuals | ||
* Hepatosplenomegaly (may become shrunken in cases of cirrhosis due to chronic infection) | * [[Hepatosplenomegaly]] (may become shrunken in cases of [[cirrhosis]] due to chronic infection) | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
* [[Jaundice]] | * [[Jaundice]] | ||
* [[Palmar erythema]] | * [[Palmar erythema]] | ||
* [[Spider angiomata]] | * [[Spider angiomata]] | ||
* [[Gynecomastia]] | * [[Gynecomastia]] | ||
* Arthritis-dermatitis syndrome | * [[Arthritis-dermatitis syndrome]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Antigen and antibody detection | * [[Antigen]] and [[antibody]] detection | ||
* Total and direct [[bilirubin]] (increased) | * Total and direct [[bilirubin]] (increased) | ||
* Severe disease is often associated with persistent [[bilirubin]] levels >340 | * Severe disease is often associated with persistent [[bilirubin]] levels >340 mmol/L | ||
* [[ALT]] and [[AST]] (increased) | * [[ALT]] and [[AST]] (increased) | ||
* [[Alkaline phosphatase]] (normal or mildly elevated) | * [[Alkaline phosphatase]] (normal or mildly elevated) | ||
Line 277: | Line 277: | ||
* [[Anemia|Low hemoglobin]] | * [[Anemia|Low hemoglobin]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Antigen and antibody detection | * [[Antigen]] and [[antibody]] detection | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Interferon]] ([[IFN]]) | * [[Interferon]] ([[IFN]]) | ||
Line 285: | Line 285: | ||
* [[Antivirals|Nucleotide analogs]] | * [[Antivirals|Nucleotide analogs]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Chronic Myelogenous Leukemia (CML)'''<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/leukemia/hp/cml-treatment-pdq#section/_19</ref><ref name="pmid24729196">{{cite journal |vauthors=Jabbour E, Kantarjian H |title=Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management |journal=Am. J. Hematol. |volume=89 |issue=5 |pages=547–56 |date=May 2014 |pmid=24729196 |doi=10.1002/ajh.23691 |url=}}</ref><ref name="pmid26434969">{{cite journal |vauthors=Thompson PA, Kantarjian HM, Cortes JE |title=Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015 |journal=Mayo Clin. Proc. |volume=90 |issue=10 |pages=1440–54 |date=October 2015 |pmid=26434969 |pmc=5656269 |doi=10.1016/j.mayocp.2015.08.010 |url=}}</ref><ref name="pmid10428738">{{cite journal |vauthors=Faderl S, Talpaz M, Estrov Z, Kantarjian HM |title=Chronic myelogenous leukemia: biology and therapy |journal=Ann. Intern. Med. |volume=131 |issue=3 |pages=207–19 |date=August 1999 |pmid=10428738 |doi= |url=}}</ref><ref name="cancer.ca">Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/treatment/chronic/?region=ab</ref><ref name="Tefferi">{{cite journal|title=Classification, diagnosis and management of myeloproliferative disorders in the JAK2V617F era|author=Tefferi A|journal=Hematology Am Soc Hematol Educ Program|date=2006|pages=240-245|pmid=17124067}}</ref><ref name="cancer.ca2">Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/signs-and-symptoms/?region=ab</ref><ref name="pmid264349692">{{cite journal |vauthors=Thompson PA, Kantarjian HM, Cortes JE |title=Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015 |journal=Mayo Clin. Proc. |volume=90 |issue=10 |pages=1440–54 |date=October 2015 |pmid=26434969 |pmc=5656269 |doi=10.1016/j.mayocp.2015.08.010 |url=}}</ref><ref name="pmid11550277">{{cite journal |vauthors=Wang YL, Bagg A, Pear W, Nowell PC, Hess JL |title=Chronic myelogenous leukemia: laboratory diagnosis and monitoring |journal=Genes Chromosomes Cancer |volume=32 |issue=2 |pages=97–111 |date=October 2001 |pmid=11550277 |doi= |url=}}</ref><ref name="pmid264349692">{{cite journal |vauthors=Thompson PA, Kantarjian HM, Cortes JE |title=Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015 |journal=Mayo Clin. Proc. |volume=90 |issue=10 |pages=1440–54 |date=October 2015 |pmid=26434969 |pmc=5656269 |doi=10.1016/j.mayocp.2015.08.010 |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Chronic myelogenous leukemia|Chronic Myelogenous Leukemia]] (CML)'''<ref name="cancergov">National Cancer Institute. Physician Data Query Database 2015.http://www.cancer.gov/types/leukemia/hp/cml-treatment-pdq#section/_19</ref><ref name="pmid24729196">{{cite journal |vauthors=Jabbour E, Kantarjian H |title=Chronic myeloid leukemia: 2014 update on diagnosis, monitoring, and management |journal=Am. J. Hematol. |volume=89 |issue=5 |pages=547–56 |date=May 2014 |pmid=24729196 |doi=10.1002/ajh.23691 |url=}}</ref><ref name="pmid26434969">{{cite journal |vauthors=Thompson PA, Kantarjian HM, Cortes JE |title=Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015 |journal=Mayo Clin. Proc. |volume=90 |issue=10 |pages=1440–54 |date=October 2015 |pmid=26434969 |pmc=5656269 |doi=10.1016/j.mayocp.2015.08.010 |url=}}</ref><ref name="pmid10428738">{{cite journal |vauthors=Faderl S, Talpaz M, Estrov Z, Kantarjian HM |title=Chronic myelogenous leukemia: biology and therapy |journal=Ann. Intern. Med. |volume=131 |issue=3 |pages=207–19 |date=August 1999 |pmid=10428738 |doi= |url=}}</ref><ref name="cancer.ca">Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/treatment/chronic/?region=ab</ref><ref name="Tefferi">{{cite journal|title=Classification, diagnosis and management of myeloproliferative disorders in the JAK2V617F era|author=Tefferi A|journal=Hematology Am Soc Hematol Educ Program|date=2006|pages=240-245|pmid=17124067}}</ref><ref name="cancer.ca2">Canadian Cancer Society.2015.http://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-myelogenous-cml/signs-and-symptoms/?region=ab</ref><ref name="pmid264349692">{{cite journal |vauthors=Thompson PA, Kantarjian HM, Cortes JE |title=Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015 |journal=Mayo Clin. Proc. |volume=90 |issue=10 |pages=1440–54 |date=October 2015 |pmid=26434969 |pmc=5656269 |doi=10.1016/j.mayocp.2015.08.010 |url=}}</ref><ref name="pmid11550277">{{cite journal |vauthors=Wang YL, Bagg A, Pear W, Nowell PC, Hess JL |title=Chronic myelogenous leukemia: laboratory diagnosis and monitoring |journal=Genes Chromosomes Cancer |volume=32 |issue=2 |pages=97–111 |date=October 2001 |pmid=11550277 |doi= |url=}}</ref><ref name="pmid264349692">{{cite journal |vauthors=Thompson PA, Kantarjian HM, Cortes JE |title=Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015 |journal=Mayo Clin. Proc. |volume=90 |issue=10 |pages=1440–54 |date=October 2015 |pmid=26434969 |pmc=5656269 |doi=10.1016/j.mayocp.2015.08.010 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* BCR/ABL gene fusion product due to translocation mutation t(9;22)(q34;q11)<ref name="pmid23147546">{{cite journal |vauthors=Zahra K, Ben Fredj W, Ben Youssef Y, Zaghouani H, Chebchoub I, Zaier M, Badreddine S, Braham N, Sennana H, Khelif A |title=Chronic myeloid leukemia as a secondary malignancy after lymphoma in a child. A case report and review of the literature |journal=Onkologie |volume=35 |issue=11 |pages=690–3 |date=2012 |pmid=23147546 |doi=10.1159/000343952 |url=}}</ref> | * [[Philadelphia chromosome|BCR/ABL gene]] fusion product due to [[Chromosomal translocation|translocation]] [[mutation]] [[Philadelphia chromosome|t(9;22)]](q34;q11)<ref name="pmid23147546">{{cite journal |vauthors=Zahra K, Ben Fredj W, Ben Youssef Y, Zaghouani H, Chebchoub I, Zaier M, Badreddine S, Braham N, Sennana H, Khelif A |title=Chronic myeloid leukemia as a secondary malignancy after lymphoma in a child. A case report and review of the literature |journal=Onkologie |volume=35 |issue=11 |pages=690–3 |date=2012 |pmid=23147546 |doi=10.1159/000343952 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Fever | * [[Fever]] | ||
* Weight loss | * [[Weight loss]] | ||
* Hepatosplenomegaly | * [[Hepatosplenomegaly]] | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
* [[Bruises]] | * [[Bruises]] | ||
Line 298: | Line 298: | ||
* [[Ulcers]] | * [[Ulcers]] | ||
* [[Vesicles]] | * [[Vesicles]] | ||
* Malaise | * [[Malaise]] | ||
* Early satiety | * [[Early satiety]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Anemia]] | * [[Anemia]] | ||
Line 314: | Line 314: | ||
* Elevated [[histamine]] levels | * Elevated [[histamine]] levels | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* | * [[Fluorescence in situ hybridization|Fluoroscent insitu hybridization (FISH)]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Imatinib]] | * [[Imatinib]] | ||
Line 323: | Line 323: | ||
* [[Cytarabine]] | * [[Cytarabine]] | ||
* [[Cytarabine|HDAC]] (high-dose cytarabine) | * [[Cytarabine|HDAC]] (high-dose [[cytarabine]]) | ||
* [[Hydroxyurea]] | * [[Hydroxyurea]] | ||
* [[Busulfan]] | * [[Busulfan]] | ||
* [[Busulfex]] | * [[Busulfex]] | ||
* Stem cell transplantation | * [[Stem cell transplantation]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Lymphoma''' | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Lymphoma]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Various causes based on type: | * Various causes based on type: | ||
** Hodgkin's | ** [[Hodgkin's lymphoma|Hodgkin's]] | ||
** Non-Hodgkin's | ** [[Non-Hodgkin lymphoma|Non-Hodgkin's]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Fever | * [[Fever]] | ||
* Weight loss | * [[Weight loss]] | ||
* Lymphadenopathy | * [[Lymphadenopathy]] | ||
* Hepatosplenomegaly | * [[Hepatosplenomegaly]] | ||
* Night sweats, constant fatigue | * [[Night sweats]], constant [[fatigue]] | ||
* Purplish scaly rash in cases of cutaneous lymphoma | * Purplish scaly rash in cases of [[cutaneous lymphoma]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Elevated ESR | * [[Erythrocyte sedimentation rate|Elevated ESR]] | ||
* Increased CRP | * [[C-reactive protein|Increased CRP]] | ||
* Increased LDH | * [[Lactate dehydrogenase|Increased LDH]] | ||
* Anemia of chronic disease | * [[Anemia of chronic disease]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Lymph node biopsy | * [[Lymph node biopsy]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Primary (AL) Amyloidosis'''<ref name="pmid25378951">{{cite journal |vauthors=Real de Asúa D, Costa R, Galván JM, Filigheddu MT, Trujillo D, Cadiñanos J |title=Systemic AA amyloidosis: epidemiology, diagnosis, and management |journal=Clin Epidemiol |volume=6 |issue= |pages=369–77 |date=2014 |pmid=25378951 |pmc=4218891 |doi=10.2147/CLEP.S39981 |url=}}</ref><ref name="pmid24998818">{{cite journal |vauthors=Misumi Y, Ando Y |title=[Classification of amyloidosis] |language=Japanese |journal=Brain Nerve |volume=66 |issue=7 |pages=731–7 |date=July 2014 |pmid=24998818 |doi= |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Primary amyloidosis|Primary (AL) Amyloidosis]]'''<ref name="pmid25378951">{{cite journal |vauthors=Real de Asúa D, Costa R, Galván JM, Filigheddu MT, Trujillo D, Cadiñanos J |title=Systemic AA amyloidosis: epidemiology, diagnosis, and management |journal=Clin Epidemiol |volume=6 |issue= |pages=369–77 |date=2014 |pmid=25378951 |pmc=4218891 |doi=10.2147/CLEP.S39981 |url=}}</ref><ref name="pmid24998818">{{cite journal |vauthors=Misumi Y, Ando Y |title=[Classification of amyloidosis] |language=Japanese |journal=Brain Nerve |volume=66 |issue=7 |pages=731–7 |date=July 2014 |pmid=24998818 |doi= |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Aggregation and deposition of immunoglobulin light chains that usually produced by plasma cell clones<ref name="pmid21360109">{{cite journal |vauthors=Bilginer Y, Akpolat T, Ozen S |title=Renal amyloidosis in children |journal=Pediatr. Nephrol. |volume=26 |issue=8 |pages=1215–27 |date=August 2011 |pmid=21360109 |pmc=3119800 |doi=10.1007/s00467-011-1797-x |url=}}</ref><ref name="pmid28134587">{{cite journal |vauthors=Khoor A, Colby TV |title=Amyloidosis of the Lung |journal=Arch. Pathol. Lab. Med. |volume=141 |issue=2 |pages=247–254 |date=February 2017 |pmid=28134587 |doi=10.5858/arpa.2016-0102-RA |url=}}</ref> | * Aggregation and deposition of [[immunoglobulin light chains]] that are usually produced by [[plasma cell]] clones<ref name="pmid21360109">{{cite journal |vauthors=Bilginer Y, Akpolat T, Ozen S |title=Renal amyloidosis in children |journal=Pediatr. Nephrol. |volume=26 |issue=8 |pages=1215–27 |date=August 2011 |pmid=21360109 |pmc=3119800 |doi=10.1007/s00467-011-1797-x |url=}}</ref><ref name="pmid28134587">{{cite journal |vauthors=Khoor A, Colby TV |title=Amyloidosis of the Lung |journal=Arch. Pathol. Lab. Med. |volume=141 |issue=2 |pages=247–254 |date=February 2017 |pmid=28134587 |doi=10.5858/arpa.2016-0102-RA |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Nephrotic syndrome (peripheral edema | * [[Nephrotic syndrome]] ([[peripheral edema]]) | ||
* Restrictive cardiomyopathy (fatigue, dyspnea, syncope) | * [[Restrictive cardiomyopathy]] ([[fatigue]], [[dyspnea]], [[syncope]]) | ||
* Peripheral neuropathy (numbness, tingling) | * [[Peripheral neuropathy]] ([[numbness]], [[tingling]]) | ||
* Hepatomegaly with elevated liver enzymes | * [[Hepatomegaly]] with elevated [[liver enzymes]] | ||
* Macroglossia | * [[Macroglossia]] | ||
* Purpura | * [[Purpura]] | ||
* Bleeding diathesis | * [[Bleeding diathesis]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Typical green birefringence under polarized light after Congo red staining (appears in red under normal light) | * Typical green birefringence under polarized light after Congo red staining (appears in red under normal light) | ||
Line 372: | Line 372: | ||
* Stem cell transplantation<ref name="pmid14734330">{{cite journal |vauthors=Skinner M, Sanchorawala V, Seldin DC, Dember LM, Falk RH, Berk JL, Anderson JJ, O'Hara C, Finn KT, Libbey CA, Wiesman J, Quillen K, Swan N, Wright DG |title=High-dose melphalan and autologous stem-cell transplantation in patients with AL amyloidosis: an 8-year study |journal=Ann. Intern. Med. |volume=140 |issue=2 |pages=85–93 |date=January 2004 |pmid=14734330 |doi= |url=}}</ref> | * Stem cell transplantation<ref name="pmid14734330">{{cite journal |vauthors=Skinner M, Sanchorawala V, Seldin DC, Dember LM, Falk RH, Berk JL, Anderson JJ, O'Hara C, Finn KT, Libbey CA, Wiesman J, Quillen K, Swan N, Wright DG |title=High-dose melphalan and autologous stem-cell transplantation in patients with AL amyloidosis: an 8-year study |journal=Ann. Intern. Med. |volume=140 |issue=2 |pages=85–93 |date=January 2004 |pmid=14734330 |doi= |url=}}</ref> | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Gaucher's Disease'''<ref name="pmid28218669">{{cite journal |vauthors=Stirnemann J, Belmatoug N, Camou F, Serratrice C, Froissart R, Caillaud C, Levade T, Astudillo L, Serratrice J, Brassier A, Rose C, Billette de Villemeur T, Berger MG |title=A Review of Gaucher Disease Pathophysiology, Clinical Presentation and Treatments |journal=Int J Mol Sci |volume=18 |issue=2 |pages= |date=February 2017 |pmid=28218669 |doi=10.3390/ijms18020441 |url=}}</ref> | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Gaucher's disease|Gaucher's Disease]]'''<ref name="pmid28218669">{{cite journal |vauthors=Stirnemann J, Belmatoug N, Camou F, Serratrice C, Froissart R, Caillaud C, Levade T, Astudillo L, Serratrice J, Brassier A, Rose C, Billette de Villemeur T, Berger MG |title=A Review of Gaucher Disease Pathophysiology, Clinical Presentation and Treatments |journal=Int J Mol Sci |volume=18 |issue=2 |pages= |date=February 2017 |pmid=28218669 |doi=10.3390/ijms18020441 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* GBA gene mutation | * [[GBA (gene)|GBA gene]] [[mutation]] | ||
* Aberrant metabolism of glucocerebroside (lipid) | * Aberrant metabolism of [[glucocerebroside]] ([[lipid]]) | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Hydrops fetalis | * [[Hydrops fetalis]] | ||
* Dry, scaly skin (ichthyosis) or other skin abnormalities | * Dry, scaly skin ([[ichthyosis]]) or other [[skin]] abnormalities | ||
* Hepatosplenomegaly | * [[Hepatosplenomegaly]] | ||
* Distinctive facial features | * Distinctive facial features | ||
* Neurological problems | * [[Neurological disorder|Neurological problems]] | ||
* Gall stones | * [[Gall stones]] | ||
* Growth retardation | * [[Growth retardation]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Hypocholesterolemia | * [[Hypocholesterolemia]] | ||
* Splenic nodules | * [[Splenic]] nodules | ||
* Cytopenias (especially thrombocytopenia) | * [[Cytopenias]] (especially [[thrombocytopenia]]) | ||
* Increased ferritin levels | * Increased [[ferritin]] levels | ||
* Increased tartarate resistant acid phosphatase (TRAP) levels | * Increased tartarate resistant acid phosphatase (TRAP) levels | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Enzyme assay for glucocerebrosidase | * Enzyme assay for [[glucocerebrosidase]] | ||
* DNA analysis for GBA mutation | * [[DNA|DNA analysis]] for [[GBA (gene)|GBA mutation]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Enzyme replacement | * [[Enzyme replacement therapy|Enzyme replacement]] | ||
* Splenectomy | * [[Splenectomy]] | ||
* Blood transfusion | * [[Blood transfusion]] | ||
|- | |- | ||
| colspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF| |'''Organ System Involvement'''}} | | colspan="2" style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF| |'''Organ System Involvement'''}} | ||
Line 408: | Line 408: | ||
| rowspan="7" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''''E = Endocrinopathy (Hypogonadism, Hypothyroidism, Hypopituitarism)''''' | | rowspan="7" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''''E = Endocrinopathy (Hypogonadism, Hypothyroidism, Hypopituitarism)''''' | ||
| rowspan="2" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hypogonadism<ref name="pmid16985909">{{cite journal |vauthors=Carnegie C |title=Diagnosis of hypogonadism: clinical assessments and laboratory tests |journal=Rev Urol |volume=6 Suppl 6 |issue= |pages=S3–8 |date=2004 |pmid=16985909 |pmc=1472884 |doi= |url=}}</ref><ref name="pmid20518947">{{cite journal |vauthors=Dandona P, Rosenberg MT |title=A practical guide to male hypogonadism in the primary care setting |journal=Int. J. Clin. Pract. |volume=64 |issue=6 |pages=682–96 |date=May 2010 |pmid=20518947 |doi=10.1111/j.1742-1241.2010.02355.x |url=}}</ref> | | rowspan="2" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hypogonadism<ref name="pmid16985909">{{cite journal |vauthors=Carnegie C |title=Diagnosis of hypogonadism: clinical assessments and laboratory tests |journal=Rev Urol |volume=6 Suppl 6 |issue= |pages=S3–8 |date=2004 |pmid=16985909 |pmc=1472884 |doi= |url=}}</ref><ref name="pmid20518947">{{cite journal |vauthors=Dandona P, Rosenberg MT |title=A practical guide to male hypogonadism in the primary care setting |journal=Int. J. Clin. Pract. |volume=64 |issue=6 |pages=682–96 |date=May 2010 |pmid=20518947 |doi=10.1111/j.1742-1241.2010.02355.x |url=}}</ref> | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Primary Hypogonadism (Hypergonadotrophic)''' | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Hypogonadism|Primary Hypogonadism]] (Hypergonadotrophic)''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Klinefelter's syndrome | * [[Klinefelter's syndrome]] | ||
* Myotonic dystrophy | * [[Myotonic dystrophy]] | ||
* Sertoli-cell tumor | * [[Germ cell tumor|Sertoli-cell tumor]] | ||
* Enzymatic defects | * [[Enzymatic]] defects | ||
* Viral orchitis (mumps) | * [[Orchitis|Viral orchitis]] ([[mumps]]) | ||
* Cryptorchidism | * [[Cryptorchidism]] | ||
* Polyglandular autoimmune syndrome | * [[Autoimmune polyendocrine syndrome|Polyglandular autoimmune syndrome]] | ||
* Testicular trauma and tumors | * [[Testicular trauma]] and [[Testicular tumor|tumors]] | ||
* Polycystic ovarian syndrome | * [[Polycystic ovary syndrome|Polycystic ovarian syndrome]] | ||
| rowspan="2" style="padding: 5px 5px; background: #F5F5F5;" | | | rowspan="2" style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Fatigue | * [[Fatigue]] | ||
* Decreased libido | * [[Decreased libido]] | ||
* Delayed secondary sexual characteristics: | * Delayed [[secondary sexual characteristics]]: | ||
** Absent/scant pubic hair | ** Absent/scant [[pubic hair]] | ||
** Impotence | ** [[Impotence]] | ||
** Erectile dysfunction | ** [[Erectile dysfunction]] | ||
** Amenorrhea | ** [[Amenorrhea]] | ||
** Delayed breast development | ** Delayed [[breast]] development | ||
** Small testicular size | ** Small [[testicular]] size | ||
* Decreased muscle mass | * Decreased [[muscle mass]] | ||
* Osteoporosis | * [[Osteoporosis]] | ||
* Depression | * [[Depression]] | ||
* Infertility | * [[Infertility]] | ||
* Irritability | * [[Irritability]] | ||
* Mood swings | * [[Mood swings]] | ||
* Pot belly | * Pot belly | ||
* Weight gain | * [[Weight gain]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Decreased sex hormone levels: | * Decreased [[Sex hormones|sex hormone]] levels: | ||
** Decreased testosterone | ** Decreased [[testosterone]] | ||
** Decreased dihydrotestosterone | ** Decreased [[dihydrotestosterone]] | ||
** Decreased estrogen | ** Decreased [[estrogen]] | ||
* Increased | * Increased [[gonadotropins]]: | ||
** Increased LH | ** Increased [[Luteinizing hormone|LH]] | ||
** Increased FSH | ** Increased [[FSH]] | ||
| rowspan="2" style="padding: 5px 5px; background: #F5F5F5;" | | | rowspan="2" style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Serum sex hormone levels | * Serum [[Sex hormone|sex hormone levels]] | ||
| rowspan="2" style="padding: 5px 5px; background: #F5F5F5;" | | | rowspan="2" style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Hormone replacement therapy | * [[Hormone replacement therapy]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Secondary Hypogonadism (Hypogonadotrophic)''' | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Hypogonadism|Secondary Hypogonadism]] (Hypogonadotrophic)''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Panhypopituitarism | * [[Panhypopituitarism]] | ||
* Hyperprolactinemia | * [[Hyperprolactinemia]] | ||
* Isolated gonadotropin deficiency | * Isolated [[gonadotropin deficiency]] | ||
* Kallman's syndrome | * [[Kallman syndrome|Kallman's syndrome]] | ||
* Congenital | * Congenital | ||
* Prader-Willi syndrome | * [[Prader-Willi syndrome]] | ||
* Hemochromatosis | * [[Hemochromatosis]] | ||
* Massive obesity | * [[Obesity|Massive obesity]] | ||
* Malnutrition | * [[Malnutrition]] | ||
* | * | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Decreased sex hormone levels: | * Decreased [[Sex hormones|sex hormone]] levels: | ||
** Decreased testosterone | ** Decreased [[testosterone]] | ||
** Decreased dihydrotestosterone | ** Decreased [[dihydrotestosterone]] | ||
** Decreased estrogen | ** Decreased [[estrogen]] | ||
* Decreased | * Decreased [[gonadotropins]]: | ||
** Decreased LH | ** Decreased [[LH]] | ||
** Decreased FSH | ** Decreased [[FSH]] | ||
|- | |- | ||
| rowspan="3" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hypothyroidism<ref name="pmid20596261">{{cite journal |vauthors=Kostoglou-Athanassiou I, Ntalles K |title=Hypothyroidism - new aspects of an old disease |journal=Hippokratia |volume=14 |issue=2 |pages=82–7 |date=April 2010 |pmid=20596261 |doi= |url=}}</ref><ref name="pmid24275187">{{cite journal |vauthors=Koulouri O, Moran C, Halsall D, Chatterjee K, Gurnell M |title=Pitfalls in the measurement and interpretation of thyroid function tests |journal=Best Pract. Res. Clin. Endocrinol. Metab. |volume=27 |issue=6 |pages=745–62 |date=December 2013 |pmid=24275187 |doi=10.1016/j.beem.2013.10.003 |url=}}</ref> | | rowspan="3" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hypothyroidism<ref name="pmid20596261">{{cite journal |vauthors=Kostoglou-Athanassiou I, Ntalles K |title=Hypothyroidism - new aspects of an old disease |journal=Hippokratia |volume=14 |issue=2 |pages=82–7 |date=April 2010 |pmid=20596261 |doi= |url=}}</ref><ref name="pmid24275187">{{cite journal |vauthors=Koulouri O, Moran C, Halsall D, Chatterjee K, Gurnell M |title=Pitfalls in the measurement and interpretation of thyroid function tests |journal=Best Pract. Res. Clin. Endocrinol. Metab. |volume=27 |issue=6 |pages=745–62 |date=December 2013 |pmid=24275187 |doi=10.1016/j.beem.2013.10.003 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Primary Hypothyroidism | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Primary hypothyroidism|Primary Hypothyroidism]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Congenital hypothyroidism | * [[Congenital hypothyroidism]] | ||
* Autoimmune (Hashimoto's) thyroiditis | * Autoimmune ([[Hashimoto's thyroiditis|Hashimoto's]]) thyroiditis | ||
* Resistance to [[TSH]] | * Resistance to [[TSH]] | ||
| rowspan="3" style="padding: 5px 5px; background: #F5F5F5;" | | | rowspan="3" style="padding: 5px 5px; background: #F5F5F5;" | | ||
Line 513: | Line 513: | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Decreased T3 and T4 | * Decreased [[Triiodothyronine|T3]] and [[Thyroxine|T4]] | ||
* Increased TSH | * Increased [[Thyroid-stimulating hormone|TSH]] | ||
| rowspan="3" style="padding: 5px 5px; background: #F5F5F5;" | | | rowspan="3" style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Serum T3, T4, TSH levels | * Serum [[Triiodothyronine|T3]], [[Thyroxine|T4]], [[Thyroid-stimulating hormone|TSH]] levels | ||
| rowspan="3" style="padding: 5px 5px; background: #F5F5F5;" | | | rowspan="3" style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Hormone replacement therapy | * [[Hormone replacement therapy]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Secondary Hypothyroidism | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Secondary hypothyroidism|Secondary Hypothyroidism]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Pituitary mass lesions, especially pituitary adenomas | * [[Pituitary gland|Pituitary]] mass lesions, especially [[pituitary adenomas]] | ||
* Brain cysts and abscesses | * [[Brain cyst|Brain cysts]] and [[Brain abscesses|abscesses]] | ||
* Meningiomas | * [[Meningiomas]] | ||
* Dysgerminomas | * [[Dysgerminoma|Dysgerminomas]] | ||
* Metastatic tumors | * [[Metastatic tumor|Metastatic tumors]] | ||
* Craniopharyngiomas | * [[Craniopharyngiomas]] | ||
* Pituitary apoplexy | * [[Pituitary apoplexy]] | ||
* Sheehan syndrome (postpartum pituitary necrosis) | * [[Sheehan syndrome]] ([[postpartum]] pituitary necrosis) | ||
* Idiopathic isolated TSH deficiency | * Idiopathic isolated [[Thyroid-stimulating hormone|TSH]] deficiency | ||
* Lymphocytic or granulomatous hypophysitis | * [[Lymphocytic hypophysitis|Lymphocytic]] or granulomatous hypophysitis | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Decreased T3 and T4 | * Decreased [[Triiodothyronine|T3]] and [[T4]] | ||
* Decreased TSH | * Decreased [[TSH]] | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Tertiary Hypothyroidism | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |[[Tertiary hypothyroidism|Tertiary Hypothyroidism]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Hemochromatosis | * [[Hemochromatosis]] | ||
* Histiocytosis | * [[Histiocytosis]] | ||
* Developmental abnormalities | * Developmental abnormalities | ||
* Internal carotid aneurysms | * [[Internal carotid artery|Internal carotid aneurysms]] | ||
* Idiopathic isolated TRH deficiency | * Idiopathic isolated [[Thyrotropin-releasing hormone|TRH]] deficiency | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Decreased T3 and T4 | * Decreased [[Triiodothyronine|T3]] and [[Thyroxine|T4]] | ||
* Decreased TRH | * Decreased [[TRH]] | ||
* Decreased TSH | * Decreased [[TSH]] | ||
|- | |- | ||
| rowspan="2" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hypopituitarism<ref name="pmid26790380">{{cite journal |vauthors=Kim SY |title=Diagnosis and Treatment of Hypopituitarism |journal=Endocrinol Metab (Seoul) |volume=30 |issue=4 |pages=443–55 |date=December 2015 |pmid=26790380 |doi=10.3803/EnM.2015.30.4.443 |url=}}</ref><ref name="pmid16597813">{{cite journal |vauthors=Prabhakar VK, Shalet SM |title=Aetiology, diagnosis, and management of hypopituitarism in adult life |journal=Postgrad Med J |volume=82 |issue=966 |pages=259–66 |date=April 2006 |pmid=16597813 |doi=10.1136/pgmj.2005.039768 |url=}}</ref> | | rowspan="2" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Hypopituitarism<ref name="pmid26790380">{{cite journal |vauthors=Kim SY |title=Diagnosis and Treatment of Hypopituitarism |journal=Endocrinol Metab (Seoul) |volume=30 |issue=4 |pages=443–55 |date=December 2015 |pmid=26790380 |doi=10.3803/EnM.2015.30.4.443 |url=}}</ref><ref name="pmid16597813">{{cite journal |vauthors=Prabhakar VK, Shalet SM |title=Aetiology, diagnosis, and management of hypopituitarism in adult life |journal=Postgrad Med J |volume=82 |issue=966 |pages=259–66 |date=April 2006 |pmid=16597813 |doi=10.1136/pgmj.2005.039768 |url=}}</ref> | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Congenital''' | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Congenital''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Idiopathic | * [[Idiopathic]] | ||
* Anatomic lesion in sella turcica (Rathke's cyst) | * Anatomic lesion in [[sella turcica]] ([[Rathke's pouch|Rathke's cyst]]) | ||
* CNS malformations: | * [[CNS]] malformations: | ||
** Septo-optic-dysplasia | ** Septo-optic-[[dysplasia]] | ||
** Kallmann syndrome | ** [[Kallmann syndrome]] | ||
** Pituitary stalk interruption syndrome | ** [[Pituitary stalk]] interruption syndrome | ||
| rowspan="2" style="padding: 5px 5px; background: #F5F5F5;" | | | rowspan="2" style="padding: 5px 5px; background: #F5F5F5;" | | ||
* [[Headache]] | * [[Headache]] | ||
Line 582: | Line 582: | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Acquired''' | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Acquired''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
* Posterior pituitary tumor: astrocytoma, ganglioneuroma | * Posterior [[pituitary tumor]]: [[astrocytoma]], [[ganglioneuroma]] | ||
* Metastatic: breast, lungs, colon, prostate | * [[Metastatic]]: [[Breast cancer|breast]], [[Lung cancer|lungs]], [[Colorectal cancer|colon]], [[Prostate Cancer|prostate]] | ||
* Peripituitary lesions: Craniopharyngioma, meningioma, chordoma, optic nerve glioma | * Peripituitary lesions: [[Craniopharyngioma]], [[meningioma]], [[chordoma]], [[optic nerve glioma]] | ||
* Transsphenoidal or transcranial surgery | * Transsphenoidal or transcranial surgery | ||
* Radiation | * [[Radiation therapy|Radiation]] | ||
* Traumatic brain injury | * [[Traumatic brain injury]] | ||
* Sheehan's syndrome | * [[Sheehan's syndrome]] | ||
* Pituitary apoplexy | * [[Pituitary apoplexy]] | ||
* Meningitis | * [[Meningitis]] | ||
* Hypophysitis | * [[Hypophysitis]] | ||
* Lymphoma | * Lymphoma | ||
|- | |- | ||
Line 660: | Line 660: | ||
* Observation | * Observation | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''Asymptomatic Plasma Cell Myeloma''' | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Multiple Myeloma|Asymptomatic Plasma Cell Myeloma]]''' | ||
('''Smoldering''' and '''Indolent plasma cell myeloma''') | [[Multiple Myeloma|('''Smoldering''' and '''Indolent plasma cell myeloma''')]] | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*[[Chromosomal aberration|Chromosomal aberrations]] or other [[Genetics|genetic]] insults | *[[Chromosomal aberration|Chromosomal aberrations]] or other [[Genetics|genetic]] insults | ||
Line 702: | Line 702: | ||
* Radiotherapy | * Radiotherapy | ||
|- | |- | ||
| colspan="2" rowspan="3" | | colspan="2" rowspan="3" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Bone Lesions | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Osteoporosis]]''' | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Osteoporosis]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
Line 766: | Line 766: | ||
*Genetic counseling for offspring | *Genetic counseling for offspring | ||
|- | |- | ||
| colspan="2" | | colspan="2" style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |Skin Changes | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Scurvy]]''' | | style="padding: 5px 5px; background: #DCDCDC; font-weight: bold; text-align:center;" |'''[[Scurvy]]''' | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
Line 778: | Line 778: | ||
*Impaired [[immune]] response | *Impaired [[immune]] response | ||
*Impaired [[wound]] healing | *Impaired [[wound]] healing | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
*[[Vitamin C]] supplementation | *[[Vitamin C]] supplementation | ||
*Citrus fruits | *Citrus fruits | ||
|} | |} | ||
Latest revision as of 23:56, 1 August 2019
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Hassan A. Kazmi BSc, MD [2]
Overview
The diagnosis of POEMS syndrome presents a diagnostic challenge for the physician. A thorough examination of organ systems should be attempted in order to reach a confirmed diagnosis. POEMS syndrome should be differentiated from other conditions presenting as a polyneuropathy (metabolic syndrome, vitamin B12 deficiency, Guillain-Barre syndrome, chronic inflammatory demyelinating polyneuropathy and multifocal motor polyneuropathy), organomegaly with lymphadenopathy (malaria, leshmaniasis or kala-azar, infective hepatitis, chronic myelogenous leukemia, lymphoma, primary amyloidosis, Gaucher's disease), endocrinopathy (hypogonadism, hypothyroidism, hypopituitarism), monoclonal plasma cell proliferation (multiple myeloma, monoclonal gammopathy of undetermined significance, plasmacytoma), mixed lytic/sclerotic bone lesions (osteomalacia, osteogenesis imperfecta) and skin changes.
Differentiating POEMS Syndrome From Other Diseases
The diagnosis of POEMS syndrome presents a diagnostic challenge for the physician. A thorough examination of organ systems should be attempted in order to reach a confirmed diagnosis. POEMS syndrome should be differentiated from other conditions presenting as a polyneuropathy, organomegaly, endocrinopathy, monoclonal plasma cell proliferation, mixed lytic/sclerotic bone lesions and skin changes. The differentials include the following:
Organ System Involvement | Differential Diagnosis | Causes | Clinical Features | Laboratory Findings | Gold Standard Test | Therapy | |
---|---|---|---|---|---|---|---|
P = Polyneuropathy | POEMS syndrome (Demyelinating)[1] |
|
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Metabolic Syndrome (Axonal pathology)[8] |
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Vitamin Deficiencies (Axonal Pathology)[10] |
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| |||
Guillain-Barre Syndrome (Demyelinating)[16] |
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Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) (Mixed axonal and demyelinatiing)[24][25] |
|
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Multifocal Motor Neuropathy[35] |
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Organ System Involvement | Differential Diagnosis | Causes | Features | Laboratory Findings | Gold Standard Test | Therapy | |
O = Organomegaly (Hepatosplenomegaly and Lymphadenopathy) | Malaria[37][38][39] |
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| |||
Kala-azar[40][41] |
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Infective Hepatitis[42][43] |
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Chronic Myelogenous Leukemia (CML)[44][45][46][47][48][49][50][51][52][51] |
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Lymphoma |
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Primary (AL) Amyloidosis[54][55] |
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Gaucher's Disease[61] |
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Organ System Involvement | Differential Diagnosis | Causes | Features | Laboratory Findings | Gold Standard Test | Therapy | |
E = Endocrinopathy (Hypogonadism, Hypothyroidism, Hypopituitarism) | Hypogonadism[62][63] | Primary Hypogonadism (Hypergonadotrophic) |
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Secondary Hypogonadism (Hypogonadotrophic) |
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Hypothyroidism[64][65] | Primary Hypothyroidism |
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Secondary Hypothyroidism |
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Tertiary Hypothyroidism |
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Hypopituitarism[66][67] | Congenital |
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| |
Acquired |
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Organ System Involvement | Differential Diagnosis | Causes | Features | Laboratory Findings | Gold Standard Test | Therapy | |
M = M-protein ( Hematological Abnormality/Plasma Cell Dyscrasias) | Multiple myeloma[68][69][70] |
|
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|
AND
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| |
Monoclonal gammopathy of undetermined significance (MGUS)[71] |
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AND
AND
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| |||
Asymptomatic Plasma Cell Myeloma |
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OR
AND/OR
AND
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| |||
Plasmacytoma |
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| ||
Bone Lesions | Osteoporosis |
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Osteomalacia[72] |
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Osteogenesis imperfecta |
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Skin Changes | Scurvy |
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Other Differentials
POEMS syndrome must also be differentiated from other similar conditions which lead to multiple endocrine disorders such as autoimmune polyendocrine syndrome, Hirata syndrome, Kearns–Sayre syndrome and Wolfram syndromes.[73][74][75][76][77]
Disease | Addison's disease | Type 1 diabetes mellitus | Hypothyroidism | Other disorders present |
---|---|---|---|---|
POEMS syndrome | + | Less common | Less common | Hypoparathyroidism Candidiasis Hypogonadism |
APS type 2 | + | + | + | Hypogonadism Malabsorption |
APS type 3 | - | + | + | Malabsorption |
Thymoma | + | - | + | Myasthenia gravis Cushing syndrome |
Chromosomal abnormalities (Turner syndrome, Down's syndrome) |
- | + | + | Cardiac dysfunction |
Kearns–Sayre syndrome | - | + | - | Myopathy Hypoparathyroidism Hypogonadism |
Wolfram syndrome | - | + | - | Diabetes insipidus Optic atrophy Deafness |
POEMS syndrome | - | + | - | Polyneuropathy Hypogonadism Plasma cell dyscrasias |
References
- ↑ Gherardi RK, Bélec L, Soubrier M, Malapert D, Zuber M, Viard JP, Intrator L, Degos JD, Authier FJ (February 1996). "Overproduction of proinflammatory cytokines imbalanced by their antagonists in POEMS syndrome". Blood. 87 (4): 1458–65. PMID 8608236.
- ↑ 2.0 2.1 Nozza A (2017). "POEMS SYNDROME: an Update". Mediterr J Hematol Infect Dis. 9 (1): e2017051. doi:10.4084/MJHID.2017.051. PMC 5584767. PMID 28894560.
- ↑ 3.0 3.1 3.2 Bardwick PA, Zvaifler NJ, Gill GN, Newman D, Greenway GD, Resnick DL (July 1980). "Plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes: the POEMS syndrome. Report on two cases and a review of the literature". Medicine (Baltimore). 59 (4): 311–22. PMID 6248720.
- ↑ 4.0 4.1 4.2 4.3 4.4 Takatsuki K, Sanada I (September 1983). "Plasma cell dyscrasia with polyneuropathy and endocrine disorder: clinical and laboratory features of 109 reported cases". Jpn. J. Clin. Oncol. 13 (3): 543–55. PMID 6315993.
- ↑ Nobile-Orazio E, Terenghi F, Giannotta C, Gallia F, Nozza A (March 2009). "Serum VEGF levels in POEMS syndrome and in immune-mediated neuropathies". Neurology. 72 (11): 1024–6. doi:10.1212/01.wnl.0000344569.13496.ff. PMID 19289745.
- ↑ Güneş HN, Bilecenoğlu NT, Şener U, Yoldaş TK (April 2015). "POEMS syndrome with peripheral and central nervous system demyelination: case report". Neurologist. 19 (4): 101–3. doi:10.1097/NRL.0000000000000017. PMID 25888197.
- ↑ "IMWG | International Myeloma Working Group (IMWG) Criteria for the Diagnosis of Multiple Myeloma".
- ↑ Schreiber AK, Nones CF, Reis RC, Chichorro JG, Cunha JM (April 2015). "Diabetic neuropathic pain: Physiopathology and treatment". World J Diabetes. 6 (3): 432–44. doi:10.4239/wjd.v6.i3.432. PMID 25897354.
- ↑ "Diagnosis and classification of diabetes mellitus". Diabetes Care. 33 Suppl 1: S62–9. January 2010. doi:10.2337/dc10-S062. PMID 20042775.
- ↑ Ekabe CJ, Kehbila J, Abanda MH, Kadia BM, Sama CB, Monekosso GL (January 2017). "Vitamin B12 deficiency neuropathy; a rare diagnosis in young adults: a case report". BMC Res Notes. 10 (1): 72. doi:10.1186/s13104-017-2393-3. PMID 28129784.
- ↑ Doi T, Kawata T, Tadano N, Iijima T, Maekawa A (February 1989). "Effect of vitamin B12 deficiency on S-adenosylmethionine metabolism in rats". J. Nutr. Sci. Vitaminol. 35 (1): 1–9. PMID 2738712.
- ↑ Berg RL, Shaw GR (February 2013). "Laboratory evaluation for vitamin B12 deficiency: the case for cascade testing". Clin Med Res. 11 (1): 7–15. doi:10.3121/cmr.2012.1112. PMID 23262189.
- ↑ Lindenbaum J, Savage DG, Stabler SP, Allen RH (June 1990). "Diagnosis of cobalamin deficiency: II. Relative sensitivities of serum cobalamin, methylmalonic acid, and total homocysteine concentrations". Am. J. Hematol. 34 (2): 99–107. PMID 2339684.
- ↑ Berg RL, Shaw GR (February 2013). "Laboratory evaluation for vitamin B12 deficiency: the case for cascade testing". Clin Med Res. 11 (1): 7–15. doi:10.3121/cmr.2012.1112. PMC 3573090. PMID 23262189.
- ↑ Lane LA, Rojas-Fernandez C (2002). "Treatment of vitamin b(12)-deficiency anemia: oral versus parenteral therapy". Ann Pharmacother. 36 (7–8): 1268–72. doi:10.1345/aph.1A122. PMID 12086562.
- ↑ Winer JB (December 2001). "Guillain Barré syndrome". MP, Mol. Pathol. 54 (6): 381–5. PMC 1187127. PMID 11724912.
- ↑ Rees JH, Gregson NA, Hughes RA (November 1995). "Anti-ganglioside GM1 antibodies in Guillain-Barré syndrome and their relationship to Campylobacter jejuni infection". Ann. Neurol. 38 (5): 809–16. doi:10.1002/ana.410380516. PMID 7486873.
- ↑ Winer JB, Hughes RA, Anderson MJ, Jones DM, Kangro H, Watkins RP (May 1988). "A prospective study of acute idiopathic neuropathy. II. Antecedent events". J. Neurol. Neurosurg. Psychiatry. 51 (5): 613–8. PMC 1033063. PMID 3404161.
- ↑ Yuki N, Koga M (October 2006). "Bacterial infections in Guillain-Barré and Fisher syndromes". Curr. Opin. Neurol. 19 (5): 451–7. doi:10.1097/01.wco.0000245367.36576.e9. PMID 16969154.
- ↑ Kimura J (April 1978). "Proximal versus distal slowing of motor nerve conduction velocity in the Guillain-Barré syndrome". Ann. Neurol. 3 (4): 344–50. doi:10.1002/ana.410030412. PMID 666277.
- ↑ Winer JB (December 2001). "Guillain Barré syndrome". MP, Mol. Pathol. 54 (6): 381–5. PMC 1187127. PMID 11724912.
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