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February 18, 1974

Münchhausen Syndrome

Author Affiliations

New York University Medical Center

JAMA. 1974;227(7):799. doi:10.1001/jama.1974.03230200057016

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To the Editor.—  We recently cared for a young woman who may offer an example of the Münchhausen syndrome, appearing as a case of ulcerative colitis.A 25-year-old woman was admitted to Bellevue Hospital because of bloody diarrhea. She told of frequent attacks during the previous five years of "colitis" with severe abdominal pain and bloody diarrhea.The patient acknowledged the past use of amphetamines, barbiturates, and narcotics. She had been treated in a psychiatric hospital. She had just signed herself out of the Columbus Hospital (New York City). On admission, everything was normal, except for bright red blood and mucus per rectum. The hematocrit value was 37%. Because of complaints of severe bilateral lower abdominal pain, the patient was given sedatives and meperidine (Demerol). Colonoscopy showed a friable, granular, hemorrhagic, and ulcerated mucosa for 8 cm, but beyond this, the colon was normal to 60 cm. Rectal biopsy revealed