A Fatal Case of Factitious Aplastic Anemia. Issue 4 (7th July 2022)

• Record Type: Journal Article
• Authors: Bade-Boon, Jordan; Dobson, Hannah; Breadon, Carolyn
• Is Part Of: Journal of psychiatric practice. Volume 28:Issue 4(2022)
• Page Start: 339
• Page End: 343
• Publication Date: 2022-07-07
• Subjects: aplastic anemia -- factitious disorder -- hematological diseases -- Munchausen syndrome -- somatoform disorders; Psychiatry -- Periodicals; Psychotherapy -- Periodicals; Mental health services -- Periodicals; 616.8917
• DOI: 10.1097/PRA.0000000000000641
• Languages: English
• ISSNs: 1527-4160

Abstract

Abstract : We report the case of a 26-year-old female who intentionally ingested busulfan, an oral chemotherapy agent, to induce severe aplastic anemia. The patient was initially thought to be suffering from idiopathic aplastic anemia, before clues suggesting the diagnosis of a factitious disorder were identified. The patient underwent a bone marrow transplant and ultimately died 5 weeks later following a lengthy admission to the intensive care unit. It is unclear whether confrontation about a patient's self-induction of physical illness is beneficial in the treatment of patients with factitious disorder. Cases such as this pose substantial diagnostic challenges, making early recognition of factitious disorder and initiation of treatment difficult. The patient described in this case report had risk factors for a factitious disorder, including age, gender, professional involvement in health care, recent loss and developmental trauma. Factitious disorder, while rare, can have lethal consequences for the patient. This diagnosis must be considered as part of a full diagnostic assessment.