Interpreting hoofbeats: can Bayes help clear the haze?

Article Abstract:

A pheochromocytoma was ruled out as a cause of hypertension in a 59-year-old man. A pheochromocytoma is a usually benign tumor of the adrenal glands or paraganglia that is characterized by increased secretion of catecholamines. The patient had a long history of mild hypertension. He had begun experiencing difficulty in controlling his blood pressure, despite treatment with drugs. A test for urinary vanilmandelic acid (VMA) revealed that the levels of VMA, an end product of catecholamine metabolism, in his urine were twice the normal level. The patient was treated with phenoxybenzamine for hypertension caused by a pheochromocytoma, despite normal levels of catecholamines in his urine. A computed tomographic (CT) scan of his adrenal glands did not reveal a pheochromocytoma. He was prescribed behavior-modification therapy.

Hypertension, Pheochromocytoma

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Hunting for the cause: how far to go

Article Abstract:

A 71-year-old man with nephrotic syndrome was diagnosed with lung cancer. Nephrotic syndrome is a kidney disorder that is commonly associated with cancer. The patient had visited his physician for stiffness and swelling in his hands and feet. He had also gained weight and had been experiencing weakness in his legs. He had a history of hyperthyroidism and had quit smoking eight years earlier. Laboratory tests revealed increased levels of protein in his urine, and his blood levels of creatinine were up slightly. He was diagnosed with nephrotic syndrome, but he did not respond to treatment with hydrochlorothiazide. He was referred to a nephrologist, and a chest X-ray found a mass in the upper lobe of his right lung. He was diagnosed with lung cancer and had surgery to remove the tumor.

Lung cancer, Nephrotic syndrome

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A little math helps the medicine go down

Article Abstract:

A 44-year-old physician with fever, difficulty breathing, fatigue, and muscle pain underwent treatment while his treating physicians searched for a diagnosis of his condition. Test results and symptoms suggested both tuberculosis and sarcoidosis, a progressive disease that can cause organ failure. The probability that the patient had tuberculosis was 70%, while the probability of sarcoidosis was over 60%. The risk of death from untreated tuberculosis could be 50%, while the risk of permanent lung damage from untreated sarcoidosis was high. Simultaneous treatment with antitubercular drugs and corticosteroids was the best course while awaiting more definitive diagnostic test results.

United States, Statistical Data Included, Analysis, Tuberculosis, Medical statistics, Sarcoidosis, Diagnosis, Differential, Differential diagnosis

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