title: Munchausen syndrome presenting as gross hematuria in two women.
abstract: Munchausen syndrome is an uncommon disorder in which patients present with fictitious disorders and a self-destructive urge to undergo invasive procedures. We present 2 cases of nurses who presented with recurrent urinary tract infections, flank pain, and gross hematuria. One patient had such severe hematuria as to require transfusions of more than 1000 U of packed red cells during a 30-year period. Both patients underwent extensive investigations--all of which were normal. One patient even underwent nephrectomy, which showed normal pathologic findings. Both were found to be phlebotomizing themselves and infusing blood into their bladders.
authors.affiliation: Division of Urology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Ben H
authors.initials: BH
authors.lastname: Chew
authors.forename: Kenneth T
authors.initials: KT
authors.lastname: Pace
authors.forename: R John D'A
authors.initials: RJ
authors.lastname: Honey
mesh_terms: D000328:Adult; D001803:Blood Transfusion; D005260:Female; D006417:Hematuria / Q000209:etiology* / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D009110:Munchausen Syndrome / Q000150:complications* / Q000523:psychology; D009392:Nephrectomy / Q000523:psychology; D018962:Phlebotomy / Q000295:instrumentation