CASE REPORTS   

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

Copyright © 2000 EDIZIONI MINERVA MEDICA

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.