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The health of Abraham Lincoln has long been a source of speculation for medical historians. This #tweetorial explores a new theory of what might have ailed the 16th US president.
CC: @AdamRodmanMD @tony_breu
#medtwitter
The health of Abraham Lincoln has long been a source of speculation for medical historians. This #tweetorial explores a new theory of what might have ailed the 16th US president.
CC: @AdamRodmanMD @tony_breu
#medtwitter
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Let's start with a poll.
What syndrome, if any, did Abraham Lincoln have?
Let's start with a poll.
What syndrome, if any, did Abraham Lincoln have?
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The theory that Lincoln had Marfan's Syndrome was described in @JAMA_current in 1964, based on marfanoid features found in a distant descendant of his great-great-grandfather.
https://jamanetwork.com/journals/jama/article-abstract/1720976
The theory that Lincoln had Marfan's Syndrome was described in @JAMA_current in 1964, based on marfanoid features found in a distant descendant of his great-great-grandfather.
https://jamanetwork.com/journals/jama/article-abstract/1720976
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It was also noted that he was tall and thin, had long/thin arms and hands, and had a prominent chin, all of which fit with a marfanoid habitus.
It was also noted that he was tall and thin, had long/thin arms and hands, and had a prominent chin, all of which fit with a marfanoid habitus.
5/ ...and is thought to have had flat feet (Lincoln's foot measurements
) that may have explained his loping gait.
) that may have explained his loping gait.
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Lincoln also had an eponymous sign named after him, "Lincoln Sign", where his foot was noted to bob with his pulse, leading to blurring in photographs. This was later associated with aortic regurgitation/root aneurysms
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1518411/?page=1
Lincoln also had an eponymous sign named after him, "Lincoln Sign", where his foot was noted to bob with his pulse, leading to blurring in photographs. This was later associated with aortic regurgitation/root aneurysms
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1518411/?page=1
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All of these features do fit with a marfanoid habitus, but the Marfan's syndrome theory has been called into doubt, particularly because Lincoln had did not have myopia, which is almost always present in Marfan's syndrome due to ectopia lentis
https://bit.ly/2Z6KDbE
All of these features do fit with a marfanoid habitus, but the Marfan's syndrome theory has been called into doubt, particularly because Lincoln had did not have myopia, which is almost always present in Marfan's syndrome due to ectopia lentis
https://bit.ly/2Z6KDbE
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Another, more recent, theory is that Lincoln had Multiple Endocrine Neoplasia type 2B (MEN2B), an autosomal dominant inherited cancer syndrome with marfanoid features.
https://bit.ly/2OVqtla
Another, more recent, theory is that Lincoln had Multiple Endocrine Neoplasia type 2B (MEN2B), an autosomal dominant inherited cancer syndrome with marfanoid features.
https://bit.ly/2OVqtla
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This theory is based on lumps noted around his mouth, which might have been mucosal neuromas, and that his mother and several of his children died of wasting diseases, which might have been cancer.
https://bit.ly/2Z1dvWN
This theory is based on lumps noted around his mouth, which might have been mucosal neuromas
, and that his mother and several of his children died of wasting diseases, which might have been cancer. https://bit.ly/2Z1dvWN
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But there are 2 main problems with the MEN2B theory:
As @DrStevenTChen noted reviewing the photo, we can't know if they are mucosal neuromas without seeing Lincoln's tongue
There's virtually no evidence for cancer in his family, and infections would've been more likely
But there are 2 main problems with the MEN2B theory:
As @DrStevenTChen noted reviewing the photo, we can't know if they are mucosal neuromas without seeing Lincoln's tongueThere's virtually no evidence for cancer in his family, and infections would've been more likely
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Which brings me to a new theory:
Loeys-Dietz syndrome
(An autosomal dominant disorder of TGF-beta, only described in 2005) https://www.ncbi.nlm.nih.gov/books/NBK1133/
Which brings me to a new theory:
Loeys-Dietz syndrome(An autosomal dominant disorder of TGF-beta, only described in 2005) https://www.ncbi.nlm.nih.gov/books/NBK1133/
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Patients with Loeys-Dietz syndrome have:
Marfanoid habitus
Aortic aneurysms/regurgitation
Widely spaced eyes (referred to as hypertelorism, which Lincoln had)
Patients with Loeys-Dietz syndrome have:
Marfanoid habitusAortic aneurysms/regurgitationWidely spaced eyes (referred to as hypertelorism, which Lincoln had)
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Have notably smooth/velvety skin, which was actually observed at Lincoln's autopsy by the pathologist
https://www.awesomestories.com/asset/view/161375
Have notably smooth/velvety skin, which was actually observed at Lincoln's autopsy by the pathologisthttps://www.awesomestories.com/asset/view/161375
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Cranial synostosis (premature closure of cranial sutures), which Lincoln and multiple relatives were observed to have likely had https://www.ncbi.nlm.nih.gov/pubmed/20856045
Cranial synostosis (premature closure of cranial sutures), which Lincoln and multiple relatives were observed to have likely had https://www.ncbi.nlm.nih.gov/pubmed/20856045
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And cleft lips/palates, which Lincoln didn't have.
But it has been theorized that his son Tad had a cleft palate, based on a cleft lip seen in photos and a severe speech impediment.
https://www.jstor.org/stable/25701790?seq=1#page_scan_tab_contents
And cleft lips/palates, which Lincoln didn't have. But it has been theorized that his son Tad had a cleft palate, based on a cleft lip seen in photos and a severe speech impediment
.https://www.jstor.org/stable/25701790?seq=1#page_scan_tab_contents
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Let's ask the poll again:
What syndrome, if any, did Abraham Lincoln have?
Let's ask the poll again:
What syndrome, if any, did Abraham Lincoln have?
