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MR Vol.14 No.1 indexに戻る
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MODERN RHEUMATOLOGY
Vol.14 No.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 |
| 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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