First Report of a Disease by Rhazes 10 Centuries Ago

Rouzbeh R. Ghafouri, Mostafa Araj-khodaei, Somaiyeh T. Targhi, Mojtaba Varshochi, Zahra Parsian, Reza Yarani, Samad E. J. Golzari

Abstract


Introduction: Abu Bakr Mohammad Ibn Zakariya Al‑Razi (865–925 CE), who was known as “Rhazes” in the west, was a famous scientist of medieval ages. He has more than 200 books and treatises. His masterpiece on medicine “Kitab Al‑Hawi Fi Al‑Tibb” contains around 900 case reports. Some of the diseases which seem to be recently reported have been stated previously, but not well described. Considering symptoms of the patient described at that time, differential diagnosis will
be discussed.

Case presentation: Rhazes described a patient with bilious fever. He had developed bloody urine and stool on the fourth day and fatigue. Subsequently, the patient’s urine and stool color turned into dark and black, respectively, and died the following day. According to Rhazes attitude, it was malignant measles. Meyerhof in his book has referred to post‑measles acute glomerulonephritis, but more appropriate differential diagnoses are compatible with this patient. Discussion: One of the
best diagnoses for this case can be Weil’s syndrome. Presence of fever, icterus, hemorrhage and renal injury, all suggest Weil’s syndrome without pulmonary involvement. The other probable diagnosis is thrombotic thrombocytopenic purpura (TTP). Meningococcal sepsis is the other possible diagnosis.

Conclusion: To sum up, as three compatible diseases with the case; have been described more than a thousand years after Rhazes (Weil’s syndrome 1886, TTP 1925 and meningococcemia 1805); if the case is either Weil’s or TTP or meningococcal sepsis, it is the frst report of the disease in the world by Rhazes.

Keywords: Malignant measles, meningococcemia, post‑measles acute glomerulonephritis, Rhazes, thrombotic thrombocytopenic purpura, Weil’s disease


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