title: [Factitious disorders. Hematologic, neurologic and dermatologic symptoms in a physician with factitious disorder].
abstract: METHODS
  A 38-year-old female physician was admitted with the suspected diagnosis of a myelodysplastic syndrome. The self-reported history was inconsistent and incoherent. On physical examination neurological and dermatological disorders could be found.
  
  
  RESULTS
  A bone marrow puncture revealed a toxicity-induced bone marrow damage. Extensive examinations to evaluate the neurological symptoms did not show any pathological findings. A toxicological screening identified opioids, benzodiazepines and promethazine.
  
  
  METHODS
  Because of the inconsistent history and the contradictory results of our clinical tests, we asked in other hospitals for past admissions and were thus able to have insight into a hospital career that grasped numerous different admission diagnoses. All presented symptoms, especially the bone marrow damage, were self-induced by the patient.
  
  
  CONCLUSIONS
  For the first time in this patient's history, a factitious disorder was diagnosed after a hospital career of almost 10 years. In this publication, the case is thoroughly presented. Additionally, the current literature is reviewed with latest recommendations for therapeutic strategies about this poorly understood disorder.
authors.affiliation: Klinik I für Innere Medizin, Universität zu Köln. martin.weihrauch@uni-koeln.de
authors.forename: M R
authors.initials: MR
authors.lastname: Weihrauch
authors.forename: K
authors.initials: K
authors.lastname: Rabe
authors.forename: M
authors.initials: M
authors.lastname: Kochanek
authors.forename: H
authors.initials: H
authors.lastname: Tesch
authors.forename: V
authors.initials: V
authors.lastname: Diehl
authors.forename: J
authors.initials: J
authors.lastname: Wolf
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005162:Factitious Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D009110:Munchausen Syndrome / Q000175:diagnosis* / Q000523:psychology; D009190:Myelodysplastic Syndromes / Q000175:diagnosis / Q000523:psychology; D010815:Physician Impairment / Q000523:psychology
vernacular_title: Artifizielle Störungen. Hämatologische, neurologische und dermatologische Symptome bei einer Arztin mit artifizieller Störung.