Factitious proteinuria - the most dominant feature in a young female patient with Munchausen syndrome.
Munchausen syndrome is a factitious disorder with predominantly physical signs and symptoms, resulting from the patient's high motivation for assuming a sick role, without any external incentives or boundaries. We report the case of a young female patient with factitious proteinuria in the nephrotic range and a fairly eventful medical history. After performing many expensive and unnecessary investigations and procedures,the real origin of the proteinuria was determined;it was found to be caused by the patient carefully adding calibrated egg albumin to her urine samples. This discovery roused suspicions about multiple, non-corroborated conditions from her history (e.g., multiple miscarriages, breast cancer, and thyroid disorders).The diversity of diseases presented by a single Munchausen patient tends to be bizarre,and thus is a challenge for health care providers to diagnose the condition. Teamwork is therefore of the utmost necessity to diagnose Munchausen syndrome.
School of Medicine, University of Zagreb, Zagreb, Croatia. ivemedex@yahoo.com
Ivana Vuković
IV
Lela
Sandra
S
Karanović
Danica
D
Matišić
Duško
D
Kuzmanić
Marijana
M
C Orić
Mirjana
M
Šimić
Bojan
B
Jelaković
D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007678:Kidney Glomerulus / Q000737:chemistry / Q000166:cytology; D009110:Munchausen Syndrome / Q000097:blood*; D010047:Ovalbumin / Q000097:blood; D011507:Proteinuria / Q000097:blood*
D010047:Ovalbumin