Failure of radioiodine treatment in Graves' disease intentionally caused by a patient: suspected Munchausen syndrome.
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.
Kinuya
Seigo
S
Department of Biotracer Medicine, Kanazawa University Graduate School of Medical Sciences, Japan. kinuya@med.kanazawa-u.ac.jp
Michigishi
Takatoshi
T
Nakajima
Kenichi
K
Kinuya
Keiko
K
Seto
Akira
A
Kuji
Ichiei
I
Yokoyama
Kunihiko
K
Tonami
Norihisa
N
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
D007457:Iodine Radioisotopes; D019275:Radiopharmaceuticals