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Factitious Disorder: An Angioedema Copycat.

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Summary

Factitious disorder involves assuming a sick role by faking symptoms. This case highlights the diagnostic challenges of factitious disorder in a patient with recurrent intubations and normal medical tests.

Keywords:
allergy and anaphylaxisanaphylaxisangioedemac1 esterase inhibitorfactitious disorder

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Area of Science:

  • Psychiatry
  • Internal Medicine

Background:

  • Factitious disorder is a mental health condition where individuals feign illness.
  • Patients with factitious disorder often undergo unnecessary medical procedures.

Observation:

  • A 28-year-old female presented with symptoms suggestive of anaphylaxis, including cough, shortness of breath, wheezing, and rashes.
  • She had a history of 19 endotracheal intubations and multiple invasive procedures.
  • Previous investigations, including laryngoscopy and C1 esterase inhibitor/C4 levels, were normal.

Findings:

  • The patient had a history of major depressive disorder, PTSD, and anxiety disorders.
  • Normal medical findings despite severe symptoms raised suspicion for factitious disorder.
  • Malingering was considered as a differential diagnosis due to the history of invasive procedures.

Implications:

  • This case underscores the complexity of diagnosing factitious disorder.
  • Factitious disorder can lead to significant iatrogenic risks and complications.
  • Recognizing factitious disorder is crucial for appropriate patient management and preventing harm.