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Panminerva Medica 1999 March;41(1):62-7

lingua: Inglese

Munchausen’s syn­drome. A ­case of fac­ti­tious hemop­ty­sis

Saed G., Potalivo S., Panzini L., Bisetti A.

From the Cardiovascular and Respiratory Sciences Department “Carlo Forlanini” Hospital “La Sapienza” State University of Rome, Rome, Italy


Factitious hemop­ty­sis is the bleed­ing ­type of Munchausen’s syn­drome, rare­ly report­ed in the lit­er­a­ture (­only sev­en­teen cas­es). After a care­ful and ­detailed lit­er­a­ture ­review, the authors ­report the ­case of a 22-­year-old work­ing­-wom­an, ­with a his­to­ry of asth­ma, Mediterranean anae­mia and recur­rent hemop­ty­sis, who was admit­ted sev­er­al ­times to the car­di­o­vas­cu­lar and Respiratory Sciences Depart­ment in the Car­lo Forlanini Hospital in 1994 for an asth­mat­ic ­attack and wheezi­ness at ­rest. During the admis­sions the ­patient under­went labor­a­to­ry ­tests (­such as the exam­ina­tion of spu­tum spec­i­mens, uri­nal­y­sis, tuber­cu­lin ­test, ­cold agglu­ti­nins and pneu­mo­trop­ic ­virus ­tests) and diag­nos­tic stud­ies (fiber­o­pt­ic bron­chos­co­py ­with bron­choal­ve­o­lar lav­age, com­pu­ter­ized tom­o­gra­phy and radiog­ra­phy of the ­chest, bron­chi­al arter­i­og­ra­phy, bron­chog­ra­phy, per­fu­sion and ven­ti­la­tion ­lung ­scan), ­because she con­tin­u­al­ly pre­sent­ed ­with hemop­ty­sis, in ­order to ­spot and dis­cov­er the ­nature of the bleed­ing. Since ­such exam­ina­tions ­failed (a few of ­them-name­ly fib­e­rop­tic bron­chos­co­pies - ­were ­even per­formed ­when she was cough­ing up ­blood) and psy­chi­at­ric con­sul­ta­tions ­revealed the pres­ence of psy­cho­log­i­cal­ly trau­mat­ic ­events in the ­patient’s his­to­ry ­which ­could ­explain the psy­cho­path­ic ­traits of her per­son­al­ity (in ­fact she was aggres­sive and ­unstable in inter­per­son­al rela­tions), a diag­no­sis of fac­ti­tious hemop­ty­sis in Munchausen’s syn­drome was ­made.

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