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Factitious Disorder Masquerading as a Life-Threatening Anaphylaxis.
Resha Khanal1, Selin Sendil1, Sharad Oli2
1UPMC Pinnacle Hospital, Harrisburg, PA, USA.
Journal of Investigative Medicine High Impact Case Reports
|March 31, 2021
Summary
Factitious disorder involves intentionally faking symptoms for the sick role. This case highlights factitious anaphylaxis mimicking real symptoms, emphasizing thorough evaluation and multidisciplinary care.
Area of Science:
- Psychiatry
- Allergy and Immunology
Background:
- Factitious disorder is characterized by intentional symptom fabrication to assume the patient role without apparent external gain.
- Chronic urticaria can present with diverse symptoms, sometimes mimicking other serious conditions.
Observation:
- A 23-year-old female with chronic urticaria presented with recurrent, severe symptoms including dyspnea and hypotension.
- Extensive diagnostic workup, including bone marrow biopsy and flow cytometry, ruled out organic causes like mast cell disorders and autoimmune conditions.
Findings:
- The patient's presentation was ultimately diagnosed as factitious anaphylaxis, a manifestation of an underlying major depressive disorder.
- Factitious anaphylaxis can present with life-threatening symptoms that closely resemble true anaphylaxis.
Implications:
- This case underscores the importance of a comprehensive clinical evaluation to differentiate factitious disorders from organic diseases.
- Early multidisciplinary team involvement is crucial for effective management of factitious disorder.
- Further evidence-based research is needed to reduce the burden and healthcare costs associated with factitious disorder.
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