title: [Factitious anemia with severe iron deficiency caused by self-venesection].
abstract: A 22-year-old unmarried female student of nurse school was admitted to our hospital because of hypochromic anemia and fever of unknown origin. She was diagnosed as having iron-deficiency anemia and was treated with iron, but progressive anemia recurred periodically. In particular, rapidly progressive anemia was observed after the patient stayed overnight, so we strongly suspected factitious anemia. A search of her locker in the sickroom and her room at home revealed many syringes, injection needles and a bottle of blood. Factitious anemia was diagnosed and she confessed to self blood-drawing. After a psychiatric consultation, anemia tended to to resolve gradually. However she did not go to the hospital after 6 months from her discharge. Physicians should consider factitious anemia in a patient with severe chronic hypochromic anemia who dose not respond to adequate iron therapy, particularly in a patient with medical training.
authors.affiliation: Osaka City University, Department of Clinical Hematology.
authors.forename: H
authors.initials: H
authors.lastname: Nakamae
authors.forename: M
authors.initials: M
authors.lastname: Hino
authors.forename: K
authors.initials: K
authors.lastname: Ohta
authors.forename: K
authors.initials: K
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Aoyama
authors.forename: N
authors.initials: N
authors.lastname: Sakai
authors.forename: C
authors.initials: C
authors.lastname: Sakamoto
authors.forename: T
authors.initials: T
authors.lastname: Hasegawa
authors.forename: T
authors.initials: T
authors.lastname: Yamane
authors.forename: N
authors.initials: N
authors.lastname: Tatsumi
mesh_terms: D000328:Adult; D000747:Anemia, Hypochromic / Q000175:diagnosis*; D005162:Factitious Disorders / Q000175:diagnosis*; D005260:Female; D006801:Humans; D018962:Phlebotomy; D016728:Self-Injurious Behavior