Hashimoto’s Thyroiditis

Other Known Aliases – autoimmune thyroiditis

Definition – autoimmune destruction of the thyroid gland

Clinical Significance – the gradual destruction of the thyroid gland will initially cause hyperthyroid symptoms, before progressing back to euthyroid, and eventually hypothyroid symptoms. As a result, the diagnosis can be tricky depending on where in the disease spectrum the patient is in. Overall, this is the most common cause/form of hypothryoidism and the most common autoantibodies are against thyroid peroxidase, thyroglobulin, and TSH receptors.

History – Named after Hakaru Hashimoto (1881-1934), a Japanese surgeon and general practioner, who received his medical doctorate from Fukuoka Medical College in 1907. He would study surgery under the direction of Hayari Miyake, Japan’s first neurosurgeon, and would publish his thesis findings on lymphomatous changes of excised thyroids in 1912, which would become the basis of his eponymous disease. He would frequently visit his patients in their homes, traveling almost exclusively by rickshaw, and was known not to charge his poorer patients any fees for his services.

References

1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
5. Up To Date. www.uptodate.com
6. Hashimoto H. Zur Kenntnis der lymphomatösen Veränderung der Schilddrüse (Struma lymphomatosa). Archiv für klinische Chirurgie. 1912;97:219-248.

Dalrymple Sign

Other Known Aliases – none

Definition – retraction of the upper eyelid in Grave’s disease causing abnormal wideness of the palpebral fissure

Clinical Significance – a classic examination of the ophthalmopathy of thyrotoxicosis in which you will see the white of the sclera clearly visible at the upper margin of the cornea with direct outward gaze.

History – Named after John Dalrymple (1803-1852), an English ophthalmologist who received his medical doctorate from the University of Edinburgh in 1827. He would spend his entire, albeit short due to ill health, career as an eye surgeon at the Royal Ophthalmic Hospital in London. He was also a skilled histologist and microscopist and was the first to publish on the findings of the Bence Jones protein of multiple myeloma. His eponymonic examination finding was published, shortly before his untimely death at 47, in his magnum opus “Pathology of the Human Eye” in 1852.

References

1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
5. Up To Date. www.uptodate.com

Tanner Stages

Other Known Aliases – sexual maturity rating

Definition – scale of physical development in children, adolescents, and adults based on primary and secondary sex characteristics

Clinical Significance – every patient will progress through each of the five stages during development, but due to innate individual variability, the rate and timing of each of the stages is highly variable. There are both a male and female scale and evaluates breast and testicular size, genitals, and pubic hair distribution.

History – Named after James Mourilyan Tanner (1920-2010), a British pediatric endocrinologist who received his medical doctorate from the University of Pennsylvania in 1944, as well as a fellowship in endocrinology from Johns Hopkins as a result of a Rockefeller exchange grant program. A supurb hurdler and athlete prior to WWII, he likely would have competed in the in 1940 Olympics. Following his training stateside, he would return to England to oversee a national study on the effects of malnutrition on children. While documenting and analyzing the data, he noticed a trend of secondary physical characteristics as children and adolescents developing into adulthood. This led to a 20-year longitudinal study on human development and the publication of his eponymous staging system in 1962 in his classic textbook “Growth at Adolescence”.

References

1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
5. Up To Date. www.uptodate.com
6. James Mourilyan Tanner. Royal College of Physicians. https://history.rcplondon.ac.uk/inspiring-physicians/james-mourilyan-tanner
7. Growth at Adolescence, 2nd ed. (1962) Oxford: Blackwell Scientific.

Addison’s Disease

Other Known Aliases – primary adrenal insufficiency

Definition – autoimmune destruction of the adrenal cortex that produces cortisol

Clinical Significance – In times of physiologic stress, the adrenal glands are unable to produce and secrete cortisol, which is a key hormone in the “fight-or-flight” response.  If the stress is significant (trauma, surgery, hemorrhage, etc.), then the patient can not mount a compensatory response to this stress and can have life-threatening consequences.

History – Named after Thomas Addison (1793-1860), an English physician who received his medical doctorate from the University of Edinburgh Medical School in 1815. He was a house physician at Guy’s Hospital and established himself as a prolific teacher and lecturer, often attracting physicians from all over London. He first described his eponymous disease in a short note in the London Medical Gazette called “Anaemia – Disease of the Suprarenal Capsules”.  This was then followed up by the more well known article “On the Constitutional and Local Effects of Disease of the Suprarenal Capsule” in 1855, which is largely considered the beginning of the study of the adrenal glands.  The disease eponym was original given to Dr. Addison by the French physician, Armand Trousseau, after fierce debate among experts as to whether the disease actually existed.

References

1. Firkin BG and Whitwirth JA.  Dictionary of Medical Eponyms. 2nd ed.  New York, NY; Parthenon Publishing Group. 1996.
2. Bartolucci S, Forbis P.  Stedman’s Medical Eponyms.  2nd ed.  Baltimore, MD; LWW.  2005.
3. Yee AJ, Pfiffner P. (2012).  Medical Eponyms (Version 1.4.2) [Mobile Application Software].  Retrieved http://itunes.apple.com.
4. Whonamedit – dictionary of medical eponyms. http://www.whonamedit.com
5. Up To Date. www.uptodate.com
6. Pearce JM. Thomas Addison (1793-1860). Journal of the Royal Society of Medicine. 2004; 97(6):297-300. [pubmed]
7. Addison T.  On the Constitutional and Local Effects of Disease of the Suprarenal Capsules.  1855.  London: Samuel Highley.