Aging differential diagnosis

This form of myositis stands apart from the classical PM/DM syndromes on account of its distinctive clinical and histopathological features. There is no clear difference in incidence between males and females and the disorder is typically one of middle or old age. In the majority of cases, progression is slow and skin involvement is not seen, so that the main question of differential diagnosis is its distinction from chronic PM. Unlike classic PM, weakness involves distal muscles as frequently as proximal muscles. CK levels are usually only moderately raised. A common finding which leads to the correct diagnosis of this condition is its nonresponsiveness to steroid treatment or other forms of immunosuppression. 

The differential diagnosis of GPC includes VKC, which also presents with giant papillae. In contrast to VKC, GPC has a history of contact lens wear, both genders are affected, all ages are affected, a milder amoimt of itching is present, and it occurs without seasonal predisposition. 

Clinical presentation involves a normal postoperative course for several weeks to 6 months, followed by vision loss that is often the only symptom but may be accompanied by photophobia, injection, anterior chamber reaction, or Amsler grid distortion. There is some evidence of an increased prevalence of early age-related macular degeneration in eyes that have imdergone cataract surgery. Also, diabetic retinopathy and clinically significant diabetic macular edema may both be exacerbated by CE. Therefore the differential diagnosis of postoperative vision loss must include these conditions. 

Clinical problems associated with reduced salivary flow include difficulty chewing foods, reduced denture retention, recurrent caries, root surface caries, and oral candidiasis (low grade). When any of these conditions are found in a patient, regardless of age, reduced salivary flow should be considered in a differential diagnosis of the problem. 

AGE inhibitors such as captopril may facilitate the differential diagnosis of renovascular hypertension diuretics such as fiirosemide (Lasix) cause rapid washout of the radiotracer or demonstrate urinary tract obstruction (Kletter 1988). 

In the Age of Witchcraft, illness was considered either natural or demonic. Since die existence of witches as the analogues of saints could not be doubted (save at the risk of incurring the charge of heresy), the existence of diseases due to the malefaction of witches could also not be doubted. Physicians were thus drawn into the afiairs of the Inquisition as experts liTlhe differential diagnosis, ijf-these two types of illnesses. 

One can simplify the approach to analyzing the causes of disorders of the Gl tract in children as congenital anomalies are not as prevalent in later life and the differential diagnosis is significantly affected by the age of the child. Thus, the entities... 

Such unease arises both from a practical point of view, in that it can be physically difficult to image the infant or young child, and from the differential diagnostic point of view, the differential diagnosis often being different at varying ages. 

Patients with this most common form of homocystinuria show evidence of involvement of the eye, the skeletal system, the vascular system, and the brain. It is important to note that individuals with cystathionine P-synthase deficiency do not manifest any abnormalities at birth and that the affected pregnancies are uneventful. Thus, this disorder, as opposed to the more rare remethylation defect variants of homocystinuria (described below), is not usually part of the differential diagnosis of the catastrophically ill newborn. Ectopia lentis does not usually appear before the age of 3 years, but most patients have some manifestations by the age of 10. The initial recognition of ocular abnormahties may be an observation by parent or physician that the iris shakes, when the head is moved rapidly. While a predilection for... 

Ectopia lends is often the first sign recognized in an undiagnosed patient and is usually present between 5 and 10 years of age [6,7]. Classically, the lens dislocates downwards, in contrast to Marfan syndrome, a condition often considered in the differential diagnosis of homocystinuria, where the lens classically dislocates upwards. Exceptions occur. Other eye findings may include retinal detachment, optic atrophy, and cataracts. 

Differential diagnosis includes solid ovarian tumors in younger age, e.g., granulosa cell tumors and teratomas. In MRI, uterine fibroma and fibrothecoma may display a similar appearance on T2-weighted images however, contrast enhancement in these tumors is less and delayed. Especially in CT, differentiation of subserosal uterine fibroids from solid dysgerminomas is not possible. 

Pustular and acneiform ICD are results of exposure to certain irritants, such as croton oil, mineral oils, tars, greases and naphthalenes. This syndrome must always be considered in conditions in which acneiform lesions develop outside the typical acne age. Those most affected are atopies and patients with seborrhoea, macroporous skin conditions or prior acne vulgaris. The pustules are sterile and transient however, subcorneal pustular eruption may also be a manifestation of allergy to trichlorethylene, which has to be considered as a differential diagnosis in patients with appropriate history (Goh 1995). 

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