title: Failure of radioiodine treatment in Graves' disease intentionally caused by a patient: suspected Munchausen syndrome.
abstract: We experienced a case with Graves' disease in which radioiodine treatment failed probably because of intentional spitting out of capsules of radioactive iodide. Chemical analysis of the substances collected from the trash in the treatment room demonstrated that its profile was the same as that of the capsules for radioiodine administration. Measurement of the iodine concentrations in a blood sample obtained at 24 h after the administration of radioiodine indicated that the patient showed iodine excess. These findings suggest that this may be a case of Munchausen syndrome.
authors.affiliation: Department of Biotracer Medicine, Kanazawa University Graduate School of Medical Sciences, Japan. kinuya@med.kanazawa-u.ac.jp
authors.forename: Seigo
authors.initials: S
authors.lastname: Kinuya
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Michigishi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nakajima
authors.forename: Keiko
authors.initials: K
authors.lastname: Kinuya
authors.forename: Akira
authors.initials: A
authors.lastname: Seto
authors.forename: Ichiei
authors.initials: I
authors.lastname: Kuji
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Norihisa
authors.initials: N
authors.lastname: Tonami
mesh_terms: D000328:Adult; D005260:Female; D006111:Graves Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000097:blood / Q000627:therapeutic use*; D009110:Munchausen Syndrome / Q000150:complications / Q000175:diagnosis*; D019275:Radiopharmaceuticals / Q000097:blood / Q000627:therapeutic use; D017211:Treatment Failure; D016312:Treatment Refusal
chemical_list: D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals