Munchausen syndrome
Alerts and Notices
Synopsis

Patients with Munchausen syndrome may have a profound understanding of hospitals, health care systems, and medical language. Reported symptoms are typically severe with vague details about the historical details of their illness or injury.
Many patients will improve during hospital observation but worsen after discharge. Pathological lying and splitting contact between health care providers are common in patients with Munchausen syndrome.
Related topics: facticial dermatitis, factitial panniculitis, factitial ulcer, malingering, Munchausen syndrome by proxy, skin popping substance abuse
Codes
ICD10CM:F68.10 – Factitious disorder imposed on self, unspecified
SNOMEDCT:
21586000 – Munchausen's syndrome
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Malingering – Conscious production of symptoms for recognized gain (as opposed to unrecognized gain by the patient in factitious disorder).
- Munchausen syndrome by proxy
- Somatic symptom disorder – Excessive distressing concern about symptoms.
- Delusional disorder – Belief in an underlying physical illness reaches delusional intensity.
- Conversion disorder – Unconscious production of symptoms (as opposed to conscious production in factitious disorder).
- Illness anxiety disorder
- Heavy metal poisoning
- Wilson disease
- Hemochromatosis
- Familial Mediterranean fever
- Hemophilia
- Epilepsy
- Inherited or acquired immune deficiency syndromes
- Mitochondrial disorders
- Substance use disorders (see addiction disorders)
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Management Pearls
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Therapy
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References
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Last Reviewed:06/30/2020
Last Updated:02/03/2021
Last Updated:02/03/2021