title: [Chronic pain and artificial diseases].
abstract: A 34-year-old woman presented with a complex pain disorder and a previous diagnosis of the rare Gitelman syndrome but with a negative genetic test. The patient was admitted to a routine ward for treatment of the pain but was transferred to the intensive care unit after suffering severe hypokalemia and a narcoleptic attack. In the period of intensive care all blood parameters were stable but on release to the normal ward severe hypokalemia immediately reoccurred. With consent the patient's belongings were inspected and many diuretics and laxatives were found. The patient admitted to uncontrolled self-medication so that the diagnosis of Gitelman syndrome also appeared to be an artificial disorder.
authors.affiliation: Klinik für Spezielle Schmerztherapie, Leopoldina Krankenhaus Schweinfurt, Gustav-Adolf-Str. 8, 97422, Schweinfurt, Deutschland, croch@leopoldina.de.
authors.forename: C
authors.initials: C
authors.lastname: Roch
authors.forename: C
authors.initials: C
authors.lastname: Knöchlein
authors.forename: J
authors.initials: J
authors.lastname: Albrecht
mesh_terms: D000328:Adult; D059350:Chronic Pain / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D003937:Diagnosis, Differential; D004232:Diuretics / Q000008:administration & dosage; D005260:Female; D053579:Gitelman Syndrome / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D006801:Humans; D007362:Intensive Care Units; D054368:Laxatives / Q000008:administration & dosage; D009110:Munchausen Syndrome / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D012651:Self Medication / Q000523:psychology; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy
chemical_list: D004232:Diuretics; D054368:Laxatives