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misdiagnosed??

Posted: Thu Jun 29, 2006 10:30 am
by Soroush Ebrahimi
Pls see

http://www.guardian.co.uk/g2/story/0,,1808179,00.html

Rgds
Soroush

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What's really up, doc?

Parkinson's disease is often misdiagnosed, according to new research. But
it's not the only illness that doctors find confusing, as Peta Bee reports

Thursday June 29, 2006
The Guardian

Parkinson's disease
· Commonly misdiagnosed as: depression, rheumatoid arthritis and other
conditions
It is estimated that five to 10% of people with Parkinson's disease, a
degenerative disease of the nervous system associated with trembling of the
arms and legs, stiffness and rigidity of the muscles and slowness of
movement, are misdiagnosed. Parkinson's affects 8,000-10,000 new people in
the UK each year: on average one person in every 500 has it.
Onset of symptoms is slow and may go unnoticed for several years but early
signs include stiffness of fingers or a stiff shoulder accompanied by
stiffness of muscles. Tremor is often noticed first and usually provokes a
visit to the doctor. However, up to 30% of sufferers may not have tremor,
which can lead to further misdiagnosis. This week's report revealed that
despite more than nine out of 10 GPs admitting to having no specialist
knowledge of Parkinson's, nearly one in five is failing to refer people
suspected with Parkinson's immediately to a specialist and instead initiate
treatment themselves.

"An accurate diagnosis and treatment from a specialist is the first step to
someone with Parkinson's being able to continue living life to the full,"
says Robert Meadowcroft, director of policy, campaigns and information at
the Parkinson's Disease Society. "The PDS is deeply concerned that some
people with Parkinson's are never referred to a specialist."

Frequent fainting
· Commonly misdiagnosed as: epilepsy
A study published a few years ago revealed that many as 40% of Britons
prescribed strong drugs for epilepsy actually have heart problems which
could easily be treated. According to researchers at Manchester Royal
Infirmary, many people who faint frequently are not having epileptic fits;
their bodies are twitching after they pass out due to a sudden drop in blood
pressure. Epilepsy is caused by temporary electrical changes in the brain.
Dr Adam Fitzpatrick, consultant cardiologist at the Manchester Heart Centre
who conducted the research, says: "These people are likely to be suffering
from a cardiovascular condition which makes them faint because of a sudden
drop in blood pressure. We don't know exactly how it is triggered but it is
accompanied by a slowing heart rate." A major epileptic episode will involve
stiffening of the limbs, followed by a rhythmic jerking and, to the
untrained eye, "It can appear that the people who are fainting are having an
epileptic fit," he adds.

Bell's palsy
· Commonly misdiagnosed as: stroke
George Clooney and Pierce Brosnan have both suffered from Bell's palsy, a
form of facial paralysis that is temporary and usually affects one side of
the face. It can last anything from a few weeks to many years. About 25
people in every 100,000 develop Bell's palsy each year and most initially
think they have suffered a stroke.
According to the Bell's Palsy Association, symptoms usually include a
drooping eye, sagging mouth, facial pain and drooling, which may lead to it
being mistaken for a stroke. There are numerous potential causes, though it
is currently thought that most cases arise from herpes simplex virus
infections (the one that gives you cold sores). Steroid therapy is the usual
treatment although there is little evidence to suggest it is effective in
the short term.

Ovarian cancer
· Commonly misdiagnosed as: irritable bowel syndrome
The UK has the highest incidence of ovarian cancer in Europe (around 7,000
women a year are diagnosed with it) yet many more cases slip through the
net, according to Kate Law, clinical director for Cancer Research UK.
"Symptoms of the disease include abdominal pain and bloating, diarrhoea,
constipation, back pain and fatigue, all of which are also common with IBS,"
she says. "For that reason many women overlook the warning signs early on."
One British study found that 60% of GPs misdiagnosed cases of the disease,
incorrectly assuming that symptoms occurred only in the late stages of
ovarian cancer. If detected early, survival rates can be up to 90%. However,
later diagnoses mean the survival rate drops to 30-40%. In the UK, 4,600
deaths occur from ovarian cancer every year, many of which could be
prevented if awareness of the symptoms improved, Law says.

Pulmonary hypertension
· Commonly misdiagnosed as: asthma
Pulmonary hypertension is a relatively rare condition (there are an
estimated 150,000 sufferers in Europe and the US) but one that has among the
highest rates of misdiagnosis. It causes breathlessness and exhaustion, yet
unlike asthma it occurs when high blood pressure builds up in the arteries
that supply the lungs. This puts pressure on the heart and reduces the
amount of oxygen that can reach the tissues.
In patients with pulmonary hypertension, the blood vessels in the lungs
constrict, making the heart work harder. It can eventually lead to heart
damage and even death. There is no cure, but there is effective medication
if given early enough. For many, the cause of the condition is unknown.
Despite its seriousness, one in five patients with PH has to wait more than
two years to get correctly diagnosed. "The lack of awareness is very
frustrating," says Iain Armstrong, chairman of the PHA-UK group and a
pulmonary hypertension nurse at Sheffield Primary Care Trust.

Hepatitis C
· Commonly misdiagnosed as: fatigue, exhaustion or stress
This potentially fatal liver disease - the actor Pamela Anderson is a
sufferer - can be caught through infected blood and is already the main
reason for liver transplants. Experts say that by 2020 it will be killing
more people than Aids.
Sometimes symptoms (including overwhelming fatigue) do not emerge for years
after infection, one reason why many people with hepatitis C are
misdiagnosed. Only 20% of sufferers realise they have the disease and less
than 1% are receiving treatment, even though 60% could benefit from the
drugs available. According to the Hepatitis C Trust, around 500,000 Britons
probably have the disease; Italy, Spain and Germany are all better at
diagnosing it. "We have a dreadfully poor track record at diagnosing the
disease," says Charles Gore, chief executive of the trust. "More than
400,000 people are unaware they are affected."
If it is caught in time, hepatitis C can be treated with drugs that cure
40-80% of those infected.