syndrome

In medicine and psychology, a syndrome refers to a combination of different symptoms ( symptoms ) that typically occur simultaneously and together. Here, with mostly swings that this "symptom association" above chance often. The word is derived from ancient Greek συνδρομή syndromḗ "the convergence, meeting" ( sc. Several symptoms).

The term syndrome is initially purely descriptive: it leaves completely open whether it is a matter of symptoms that are causally or pathologically-anatomically connected, and is independent of this. Sometimes a reliable diagnosis of a specific symptom is not possible in everyday clinical practice. A “syndrome” is often used to indicate that at least a rough, preliminary diagnostic assignment is attempted.

Application of the term

How several symptoms are causally related remains more or less unknown - as long as a diagnostic assignment to a disease with an already known cause has not been successful. The exact connection between individual symptoms can usually only be guessed at. The origin and development of symptoms (the pathogenesis ) are also often unknown.

Therefore, several symptoms appearing at the same time are of greater importance. By establishing a purely statistical correlation or by observing individual already “familiar” symptoms, an explanation or even a regularity in the causal sense can be assumed, at least hypothetically, for the entire group of symptoms.

Syndrome in a broader sense

Many scientific papers describe disease cases in which several key symptoms or even Keynotes first as a syndrome in the strict sense have been described and observed. If it then turns out that the descriptions made on the basis of individual cases also apply to some other cases, this extends the validity of the individual case observation. One can then speak of a syndrome in the broader sense .

This principle is particularly important in terms of the history of medicine, as the pre-Socratics had already followed corresponding considerations when determining signs of illness. Reason for such consideration arises in particular if the agreement of the description suggests a possible causal relationship in other cases as well, due to an almost identical symptom pattern. Further relationships arise, for example, due to complaints that can be assigned to pathological-anatomical findings. A known syndrome is used when the symptoms are at least in some respects uniform and in comparable cases similar symptoms, see also the concept of the disease unit . The German psychiatrist Alfred E. Hoche (1865–1943) viewed syndromes as second-order units between the elementary symptoms and the disease units. The term symptom complex also has a meaning comparable to the term syndrome .

Cross-section and longitudinal section

The temporal "convergence" or "meeting" of signs of illness is mostly understood as the simultaneous presence of different symptoms. This simultaneous manifestation of signs of illness is also called the cross-sectional image of a disease.

A syndrome can also be a staggered “running one after the other” and “meeting” of various symptoms, which only appear one after the other as individual additional symptoms during the course of a certain condition. Then one speaks of the presence of a syndrome in the longitudinal section .

Related or similar terms

The use of the term syndrome is often synonymous with other terms, such as symptom complex or symptom cluster . The term symptom , which was already used in ancient Greece , has something related to the individual case, almost accidental and not necessarily something typical. In contrast, the term syndrome, especially in its broader meaning, does not have this individual case-related connotation so obviously. It is therefore also referred to as symptomatic treatment if it is aimed at the individual symptoms and less at a cause.

Syndromes often accompany a previously known picture in the longitudinal section of the course of the disease. For example, in the further course of this disease, alcohol addiction can be complicated by Korsakoff syndrome . This syndrome runs along with it, so to speak, it occurs in the further course of an already known previous illness. This distinguishes the use of the term syndrome from the general term for symptomatology, which encompasses all symptoms .

Syndromes are sometimes combinations of other known disease units or behavioral variants, see DIDMOAD syndrome as a combination of diabetes insipidus , diabetes mellitus , atrophy of the optic nerve and deafness. As in Chap. Syndrome in a broader sense , the question whether a causal or other type of connection between the various disease units can be established between the individual syndromes. It is similar with the problem of comorbidity .

Naming of syndromes

The term syndrome goes back to Jürgen Spranger . If both the etiology and the pathogenesis are known, it is a typical or classified clinical picture .

The naming of syndromes is sometimes done eponymically after the author who first wrote it, see the Korsakow syndrome already mentioned . Pathogenetic ideas also lead to corresponding terms, such as in the apallic syndrome . Here it is assumed that the failure of the neocortex (pallium = coat - of the brain) triggers the patient's symptoms and determines the further course. Sometimes there is also an acronym for the main symptoms, such as in the case of DIDMOAD syndrome or BNS cramps (lightning-nick-salam-cramps).

If three symptoms typically occur together, doctors speak of a triad (for example "Merseburg triad" in Graves disease ), for four of a tetralogy (for example Fallot tetralogy ), for five of a pentalogy .

Examples

• apallic syndrome
• Adrenogenital Syndrome
• Acquired Immune Deficiency Syndrome (AIDS; " Acquired Immune Deficiency Syndrome ")
• Age syndromes
• Respiratory distress syndrome in adults
• Asperger's Syndrome (now obsolete)
• Down syndrom
• Flammer Syndrome
• Functional Syndromes
• Congenital squint syndrome
• Post-thrombotic syndrome
• Severe Acute Respiratory Syndrome (SARS; "Severe Acute Respiratory Syndrome")

Pseudosyndromes

Key symptoms easily turn into pseudosyndromes, especially if the exact diagnosis is difficult.

For example, the following syndromes can be viewed as such pseudosyndromes or as more or less fantasy-based names or as more or less vague descriptions:

• Founder syndrome
• Munchausen Syndrome
• Lazarus syndrome
• Odysseus Syndrome
• Metabolic syndrome
• Shoulder arm syndrome

Further use of the term

• In sociology , a group of characteristics or factors, the combined occurrence of which indicates a certain connection or condition, is also called a syndrome. Examples: syndrome of obesity in the United States , syndrome of household debt , etc.
• In coding theory , a branch of applied mathematics , the term syndrome stands for the “symptoms of errors” that can occur in a code word in the context of digital data transmission or data storage. The term is used in the context of various error correction procedures . A syndrome in a linear code is defined as a multiplication of a received or read, possibly invalid code word at the receiver (decoder) with the test matrix (control matrix ) and is an essential property only dependent on the error that may have occurred and not on the code word sent. If there is no error, the syndrome  s is therefore always equal to the zero vector . If there is a transmission error , the syndrome s indicates the  faulty data location as a vector, which can then be corrected.

See also

• List of syndromes
• Syndrome analysis
• Complex (medicine)
• 1950s syndrome

Web links

Wiktionary: Syndrome  - explanations of meanings, word origins, synonyms, translations

Individual evidence

1. ^ Rolf-Dieter Stieglitz : Diagnostics and Classification in Psychiatry. Kohlhammer Verlag, 2008, ISBN 978-3-17-018944-7 , chap. 4.2, p. 44f.
2. ↑ syndrome. In: Digital dictionary of the German language . Retrieved May 18, 2020 ( Etymology Section ).
3. ↑ syndrome. In: Norbert Boss (Ed.): Roche Lexicon Medicine. 2nd Edition. Hoffmann-La Roche AG and Urban & Schwarzenberg, Munich 1987, ISBN 3-541-13191-8 , p. 1659. Gesundheit.de/roche
4. ^ Jürgen Spranger: Disease, syndrome, sequence. In: Pediatrics. 137, 1989, p. 2.
5. ↑ ^{a b} symptom. In: Hans-Georg Gadamer : About the hiddenness of health . (= Library Suhrkamp. Volume 1135). Frankfurt am Main 1993, ISBN 3-518-22135-3 , p. 138.
6. ↑ ^{a b c} syndrome. In: Norbert Boss (Ed.): Roche Lexicon Medicine. 2nd Edition. Hoffmann-La Roche AG and Urban & Schwarzenberg, Munich 1987, ISBN 3-541-13191-8 , p. 1659. Gesundheit.de/roche
7. ↑ Rudolf Degkwitz et al. (Ed.): Mentally ill. Introduction to Psychiatry for Clinical Study. Urban & Schwarzenberg, Munich 1982, ISBN 3-541-09911-9 , Part II: Description and structure of mental illness; Cape. 5.1 Terms from general pathology, column indicated below with ~, p. 49 ~ 2 on Stw. “Syndrome”.
8. ↑ Jules fear : The course of schizoaffective psychoses. In: Andreas Marneros (Ed.): Schizoaffective Psychoses. Diagnosis, therapy and prophylaxis . Springer, Berlin 1989, ISBN 3-540-51243-8 , p. 47 on Stw. "Longitudinal and cross-sectional views in the presence of syndromes".
9. ↑ symptom. In: Willibald Pschyrembel : Pschyrembel. Clinical Dictionary. 154-184. Edition. Walter de Gruyter & Co., Berlin 1964, p. 856.
10. ↑ J. Spranger In: Paediatrics. 137, 1989, p. 2.
11. ↑ Rudolf Gross, Markus Löffler: Principles of Medicine: An overview of their bases and methods. Retrieved November 10, 2015 .  
12. ^ W. Wölk: Diagnosis versus pseudo-syndrome related medicine. In: Association of Life Insurance Companies V. and Association of Private Health Insurance e. V. (Ed.): Insurance medicine . Volume 46, Number 1, February 1994, pp. 20-22. PMID 8146947 .

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