Munchausen syndrome – forgotten but dangerous disease. Diagnostic challenges in female patient
 
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1
Katedra i Oddział Kliniczny Psychiatrii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
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Oddział Anestezjologii i Intensywnej Terapii, Wojewódzki Szpital Specjalistyczny nr 4 w Bytomiu
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Katedra i Zakład Radiologii Lekarskiej i Radiodiagnostyki, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach
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PSYCHOMedical w Bielsku-Białej
CORRESPONDING AUTHOR
Mariusz Sołtysik   

Katedra i Oddział Kliniczny Psychiatrii, Wydział Lekarski z Oddziałem Lekarsko-Dentystycznym w Zabrzu, Śląski Uniwersytet Medyczny w Katowicach, Wielospecjalistyczny Szpital Powiatowy nr 3, ul. Pyskowicka 47–51, 42-600 Tarnowskie Góry
 
Ann. Acad. Med. Siles. 2018;72:203–208
 
KEYWORDS
TOPICS
ABSTRACT
According to the International Statistical Classification of Diseases and Related Health Problems ICD-10, Munchausen syndrome is a mental disorder classified as an F68.1 diagnosis code – “Intentional production or feigning of symptoms or disabilities, either physical or psychological [factitious disorder]”. In contrast to people consciously simulating ailments for specific benefits, patients with suspected Munchausen syndrome persistently contacting health care providers are not aware of their inner motives (social gratification, need for control, high levels of self-harm), exposing themselves to a long diagnostic process.

OBJECTIVE::
To present the difficulties associated with differentiation, diagnosis and appropriate treatment of Munchausen syndrome. The presented case study concerns a young patient repeatedly hospitalized due to numerous somatic complaints. Despite many physical examinations, including imaging and treatment no diagnosis could be made which would explain all of the symptoms. Only psychiatric hospitalization, with full analysis of the patient’s medical history, made it possible to diagnose the Munchausen syndrome and to treat the patient accordingly. Paradoxically, that diagnosis might have contributed to undermining subsequent problems reported by the patient that emerged because of an expanding brain tumor.

COMMENT::
Proper understanding of the symptoms presented by the patient could have lead to a faster diagnosis. However, the later fatal symptoms show that one cannot focus on only one diagnosis. Properly planned imaging seems to play a huge role.

 
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