The eleventh revision of the International Classification of Diseases (ICD-11) has accelerated a trend away from using people’s names and toward a more descriptive or etiologically based nomenclature for diseases. The most recent example is substituting the granulomatosis with polyangiitis (Wegener’s) for the vasculitis currently known as Wegener’s granulomatosis.
“Part of this process is being driven by ICD-11 and associated conversations about illnesses that have no widely accepted name,” says ACR President David Borenstein, MD, clinical professor of medicine in the division of rheumatology at The George Washington University Medical Center, a rheumatologist at Arthritis and Rheumatism Associates in Washington, D.C., and a member of The Rheumatologist’s editorial board. “While this is going on, there is also a push to do away with eponyms and define diseases more by the pathophysiological mechanism.”
Named Diseases Concern Other Specialties
Concerns about named illnesses are also being addressed in other specialty areas.
“Dermatology probably has even more eponym chaos than we do in rheumatology,” says Eric Matteson, MD, chair of the division of rheumatology at the Mayo Clinic in Rochester, Minn. “They have several different names for the same disease and through the auspices of the International League of Dermatology Societies they are working on a more rational nomenclature for ICD-11. The American Academy of Dermatology has been awarded a grant from the National Institutes of Health to develop a lexicon to address these issues.”
Why Not Use Eponyms?
In addition to lack of consistent naming conventions, those involved point to other concerns about identifying a disease process with a specific person. Sometimes a person has had a disease process named after them because they were the first to describe it in the literature. In other instances, the person for which it was named was a later contributor but was better known or more prolific.
H. Klinger first described granulomatosis with polyangiitis in 1931 as a variant of polyarteritis nodosa. Friederich Wegener followed up in 1936 and 1939 with two articles describing it in greater detail as a separate syndrome. Wegener’s name was attached to the disease in English language literature in 1954.
“Eponyms are said to be a way to recognize those who have gone before us and made major contributions that should not be forgotten,” says Dr. Matteson. “While we should remember these people, the need to recognize one’s heroes with naming is a superfluous exercise that doesn’t really help us in medicine.”