title: Hypogammaglobulinemia factitia- Munchausen syndrome masquerading as common variable immune deficiency.
abstract: BACKGROUND
  We describe the first case of a patient with factitious disorder who closely simulated a primary immune deficiency disorder - Common Variable Immune Deficiency (CVID), by surreptitiously ingesting non-steroidal anti-inflammatory agents.
  
  
  METHODS
  He was treated with several expensive and potentially dangerous drugs before the diagnosis was established through collateral information. In retrospect he did not meet the proposed new criteria for CVID. These criteria may prove useful in distinguishing cases of CVID from secondary hypogammaglobulinemia.
  
  
  CONCLUSIONS
  It is imperative clinicians recognise patients with factitious disorder at the earliest opportunity to prevent iatrogenic morbidity and mortality.
authors.forename: Rohan
authors.initials: R
authors.lastname: Ameratunga
authors.forename: Paul
authors.initials: P
authors.lastname: Casey
authors.forename: Susan
authors.initials: S
authors.lastname: Parry
authors.forename: Chris
authors.initials: C
authors.lastname: Kenedi