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Munchausen's syndrome in the allogeneic stem cell transplantation setting: a rare but potentially devastating condition

Bone Marrow Transplantation volume 45, pages 600–601 (2010)Cite this article

Munchausen's syndrome is an extreme variant of factitious disorders, accounting for <10% of diseases in this group.1 The main feature is simulation of physical or psychiatric symptoms and signs, or both, with no apparent motivation other than adopting the role of being a patient.2 Interestingly, one-third of reported adult Munchausen's syndromes has included hematologic features,1, 3 including self-induced anemia (autophlebotomy or hemorrhagica histrionica), hemolytic anemia, or coagulopathy.1, 3 We herein describe the first case of Munchausen's syndrome related to allogeneic transplantation.

A 23-year-old female was brought to our emergency department on Friday evening with neurological symptoms. On account of patient's somnolence, the initial history was taken from her parents in law who mentioned she was treated for acute lymphoblastic leukemia in relapse at another institution and awaiting a second allogeneic transplant. Physical examination revealed a somnolent young woman with normal vital signs, without alopecia or central line. A gastric tube was in place, apparently inserted for night feeding because of chemotherapy-related nausea. Neurological examination was otherwise unremarkable. Complete blood counts, smear, and biochemistry tests were also found to be normal. Urgent brain scan and magnetic resonance imaging, as well as electroencephalogram, were unrevealing.

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Authors and Affiliations

  1. Blood and Marrow Transplant Program, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec, Canada

    M-A Archambault-Grenier, J Roy, S Cohen, S Lachance & T Kiss

  2. Department of Psychiatry, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec, Canada

    N Beauchemin

Authors
  1. M-A Archambault-Grenier
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  2. J Roy
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  3. N Beauchemin
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  4. S Cohen
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  5. S Lachance
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  6. T Kiss
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Correspondence to T Kiss.

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Archambault-Grenier, MA., Roy, J., Beauchemin, N. et al. Munchausen's syndrome in the allogeneic stem cell transplantation setting: a rare but potentially devastating condition. Bone Marrow Transplant 45, 600–601 (2010). https://doi.org/10.1038/bmt.2009.192

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