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MODERN RHEUMATOLOGY Vol.14 No.1
>MR14-1
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| Munchausen syndrome with foreign-body granuloma mimicking rheumatic diseases |
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| Masashi Kohno1 , Hitoshi Hasegawa1, Hironari Niiya1, Eiji Sada2, Masao Ono3, Masato Nose3 and Shigeru Fujita1 |
(1) First Department of Internal Medicine, Ehime University School of Medicine, Shigenobu, Onsen-gun, Ehime, 791-0295, Japan
(2) Ehime College of Health Science, Tobe, Ehime, Japan
(3) Department of Pathology, Ehime University School of Medicine, Ehime, Japan
(4) Present address: Division of Internal Medicine, Uwajima Social Insurance Hospital, 2-1-37 Gako-cho, Uwajima, 798-0053, Japan |
Received: 23 January 2003 Accepted: 23 July 2003 |
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Abstract |
| Abstract A 37-year-old man was admitted to our hospital because of fever, polyarthralgia, and subcutaneous tumors. There was swelling of the bilateral wrists and ankles, and subcutaneous tumors over the bilateral elbow joints. Despite his complaints of multiple symptoms, clinical investigations failed to reveal any abnormality. Although laboratory parameters improved rapidly after steroid therapy, the symptoms remained unchanged, and there was an enormous discrepancy between the laboratory data and his symptoms. A biopsy specimen from one of the subcutaneous tumors revealed foreign-body granuloma associated with a foreign body fragment. Because the nursing staff later discovered that the patient had been carrying out self-injection, a diagnosis of Munchausen syndrome was made. Munchausen syndrome should be included in the differential diagnosis of rheumatic diseases. |
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| Key words |
| Key words Factitious illnesses - Foreign body granuloma - Munchausen syndrome - Self-injection |
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