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A case of factitious aplastic anemia
R Bright1, S Eisendrath, L Damon
1Department of Psychiatry, UNC School of Medicine, 27599-7160, USA.
International Journal of Psychiatry in Medicine
|April 13, 2002
Summary
Factitious aplastic anemia caused by busulfan ingestion led to severe medical issues and over $1.1 million in costs. Early recognition of factitious hematologic illness in healthcare providers is crucial.
Area of Science:
- Hematology
- Toxicology
- Psychiatry
Background:
- Busulfan is a chemotherapy agent for chronic myelogenous leukemia.
- Factitious disorders involve intentional self-harm or illness simulation.
- Hematologic abnormalities can be intentionally induced.
Observation:
- A healthcare provider factitiously induced aplastic anemia via busulfan ingestion.
- Complications included bone marrow suppression, hip necrosis, and sepsis.
- Patient exhibited noncompliance and self-harm behaviors.
Findings:
- Covert busulfan ingestion caused life-threatening aplastic anemia.
- Medical costs exceeded $1,100,000.
- Diagnosis requires high suspicion in atypical cases.
Implications:
- Primary care physicians must consider factitious disorders in unexplained hematologic abnormalities.
- Young female healthcare providers with atypical presentations warrant increased suspicion.
- Early diagnosis and intervention are critical for patient outcomes and cost containment.