Maybe FDR didn't have polio...

[zakur]

Maybe FDR didn't have polio, scientists say

WASHINGTON (Reuters) -- Franklin Delano Roosevelt, the four-term president who directed his sweeping social policies from his wheelchair, may not have been struck by polio but instead by Guillain-Barre syndrome, researchers said Friday.

The symptoms of Roosevelt's illness, which first became apparent in 1921, more closely resembled those of Guillain-Barre, also known as acute ascending polyneuritis, a team at the University of Texas Medical Branch in Galveston said.

[...]

There are no diagnostic tests for Guillain-Barre but it is assessed on the basis of its symptoms. With polio, a test of the fluid found in the spinal cord can confirm the diagnosis.

Fascinating.

 

[Dr. Imago]

Guillian-Barre often follows a prodromal viral (or camplyobacter, which has also been indicted) infection, and people usually fully recover from it. It's course is months long, not years. Having it as a chronic condition is a far less common manifestation than the brief, albeit debilitating, course that it normally follows.

My opinion: not (likely) Guillian-Barre (but, maybe not poliomyelitis either). Who knows? Why speculate? For UTMB to get press?

Rules of diagnostic roundsmanship:

1) Common things occur commonly.
2) When in doubt, consider uncommon manifestations of common illnesses, rather than common manifestations of uncommon illnesses.
3) When you hear hoofbeats, think horses not zebras.
4) The race may not always be to the swift nor the battle to the strong, but it's best to bet that way.

(Or something like that.)

-TT

 

[baggie]

3) When you hear hoofbeats, think horses not zebras.
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-TT

you have never been in africa

 

[arcticpenguin]

I always hated these 'historical diagnoses'. You can find many of them; Beethoven and Lincoln are favorite targets. They are worthless unless there is a way to check up on the postdiction, and who would do that, even if possible? Does it matter whether Beethoven suffered from lead poisoning or not?

 

[Dr. Imago]

you have never been in africa

You know, this is actually an excellent point. Thank you for making it. If I were in Africa, the reverse would be true: expect zebras, not horses. There are, in fact, regional diseases that predominate in certain parts of the world and must be given preference when considering a diagnosis. For instance, in South America there is Chagas disease which is a result of trypanosomiaisis, an important cause of cardiac problems. This is why good clinicians will, as part of your medical history, ask if you've been traveling to regions where certain infectious diseases are endemic.

Excellent point, despite the fact that it was likely only intended tongue-in-cheek. And, of course, with my specific example, I'd suppose that you'd really expect to see llamas, not horses, as well...

-TT

 

[zakur]

And, of course, with my specific example, I'd suppose that you'd really expect to see llamas, not horses, as well...

Llamas do not have hooves. They have two-toed padded feet with a toenail which grows over the top of each toe.

 

[arcticpenguin]

Here's another historical diagnosis: Alexander the Great died of West Nile Fever (?)
(subscription only?)

Marr and Calisher cite a passage by the Greek biographer Plutarch. "When [Alexander] arrived before the walls of [Babylon]," Plutarch recorded, "he saw a large number of ravens flying about and pecking one another, and some of them fell dead in front of him."

The ravens might have been dying of West Nile virus infection, the researchers suggest. Ravens belong to a family of birds that are particularly susceptible to the pathogen - members of the same family are responsible for the virus' spread across the United States.
...
"It's fairly compelling," says Thomas Mather, an epidemiologist at the University of Rhode Island in Kingston. But West Nile virus tends to kill the elderly or those with weakened immune systems, he points out. "If he was so great, he might not have been bumped off by this disease," Mather says.

"Compelling"?